NPIMap

Individual provider Active NPI

Waleed Abdul Ibrahim, M.D.

  • Gastroenterology Physician
  • Modesto, CA
National Provider Identifier
1407052244
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A77739 Issued in CA
Practice address
1541 Florida Ave
Suite 200
Modesto, CA 95350
Phone
(209) 577-3388
Fax
(209) 523-0764
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A77739 CA Primary

Addresses

Primary practice location

1541 Florida Ave
Suite 200
Modesto, CA 95350

Mailing address

1541 Florida Ave
Suite 200
Modesto, CA 95350
Phone (209) 577-3388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080407000277 CA Practitioner - Gastroenterology 5395822951 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Choice Physician PartnersGroup PAC ID 0941465322, 130 clinicians

Practice addresses (Care Compare)

1541 Florida Ave
Suite 200
Modesto, CA 95350-4438
Phone (209) 577-3388

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.99 of 100Reported as individual
Quality
74.71
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
71.65
Improvement activities
40
Cost
57.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy139
Upper gastrointestinal (GI) endoscopy for acid reflux324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77739CAMDPharmacist
A77739CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Faculty Medical Group CurrentSince Jan 10, 2024 Accepting new patients
First Choice Physician Partners Family Medicine CurrentSince Mar 1, 2014 Accepting new patients
County of San Joaquin CurrentSince Jan 10, 2024 Accepting new patients
First Choice Physician Partners Current Accepting new patients
First Choice Physician Partners CurrentSince Mar 1, 2014 Accepting new patients
County of San Joaquin CurrentSince Jan 10, 2024 Accepting new patients
Memorail Hospital of Los Banos Past Accepting new patients
Lodi Memorial Hospital Association Inc Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Gardena Hospital LP Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

11234 Anderson St
Ste 1405
Loma Linda, CA 92350
Phone (909) 558-4252

1541 Florida Ave
Ste 200
Modesto, CA 95350
Phone (209) 214-7053

1444 Florida Ave
Modesto, CA 95350
Phone (209) 576-1750

1541 Florida Ave
Ste 101
Modesto, CA 95350
Phone (209) 575-3839

1541 Florida Ave
Modesto, CA 95350
Phone (209) 214-7049

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: waleed.ibrahim.1@14035.direct.athenahealth.com

Organizations & group practices 12

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1407052244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "SUITE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-577-3388",
            "fax_number": "209-523-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "SUITE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-577-3388",
            "fax_number": "209-523-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "WALEED",
        "middle_name": "ABDUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A77739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.