Individual provider Active NPI

Zenabou Ibrahim

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
National Provider Identifier
1376807412
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1037457 Issued in DC
Practice address
2600 Bryan PL SE
Washington, DC 20020-4417
Phone
(202) 553-1912
NPI assigned
Jul 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R214678 MD
Home Health Aide 374U00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1037457 DC Primary

Addresses

Primary practice location

2600 Bryan PL SE
Washington, DC 20020-4417

Mailing address

133 57TH St SE
Washington, DC 20019-6582
Phone (202) 553-1912

Other practice location 1

133 57 TH SE
Washington, DC 20019-2457
Phone (202) 553-1912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609002878 DC Practitioner - Nurse Practitioner 4284144262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7600 Georgia Ave NW
Suite 304
Washington, DC 20012-1616
Phone (202) 553-1912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1037457DCMDPsychiatric/Mental Health Nurse Practitioner
R214678MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Star Healthcare Psychiatric/Mental Health CurrentSince Apr 29, 2025 Accepting new patients

Locations

7600 Georgia Ave NW
Ste 304
Washington, DC 20012
Phone (202) 553-1912

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1376807412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 57TH ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200196582",
            "telephone_number": "202-553-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 BRYAN PL SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204417",
            "telephone_number": "202-553-1912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 57 TH SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200192457",
            "country_code": "US",
            "telephone_number": "202-553-1912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "ZENABOU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R214678",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "1037457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.