NPIMap

Individual provider Active NPI

Ibrahim Issa Hanna, M.D.

  • Internal Medicine Physician
  • Glendora, CA
National Provider Identifier
1407898653
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A50259 Issued in CA
Practice address
640 W. Foothill Blvd.
Suite 100
Glendora, CA 91741-2403
Phone
(626) 335-4041
Fax
(626) 335-3768
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A50259 CA Primary

Addresses

Primary practice location

640 W. Foothill Blvd.
Suite 100
Glendora, CA 91741-2403

Mailing address

640 W. Foothill Blvd.
Suite 100
Glendora, CA 91741-2403
Phone (626) 335-4041

Other identifiers 3

IdentifierTypeStateIssuer
00A502591MedicaidCA
P00936005OtherCAMEDICARE RR
110238745OtherCAMEDICARE RR

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
I20100422000257 CA Practitioner - Internal Medicine 5597892638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

640 W Foothill Blvd
Suite 100
Glendora, CA 91741-2456
Phone (626) 335-4041

Hospital & facility affiliations

  • Inland Home Health Providers Inc Home health agency, Rancho Cucamonga, CA, CCN 058239
  • Golden Years Home Health, Inc. Home health agency, San Dimas, CA, CCN 059592
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782
  • Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Merit-based Incentive Payment System (MIPS)

Final score
93.46 of 100Reported as individual
Quality
86.92
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions16
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50259CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ibrahim Hanna, M.D., Inc. Internal Medicine CurrentSince Jun 1, 2011 Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

640 W Foothill Blvd
Ste 100
Glendora, CA 91741
Phone (626) 335-4041

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ibrahim.hanna.p157@direct.healthcarepartners.nextgenshare.com

Organizations & group practices 3

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 6

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1407898653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W. FOOTHILL BLVD.",
            "address_2": "SUITE 100",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412403",
            "telephone_number": "626-335-4041",
            "fax_number": "626-335-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W. FOOTHILL BLVD.",
            "address_2": "SUITE 100",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412403",
            "telephone_number": "626-335-4041",
            "fax_number": "626-335-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "IBRAHIM",
        "middle_name": "ISSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A502591",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00936005",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "110238745",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.