NPIMap

Individual provider Active NPI

Magued Ibrahim, M.D.

  • Family Medicine Physician
  • Debary, FL
National Provider Identifier
1407901135
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME944332 Issued in FL
Practice address
2836 Enterprise Rd
Suite #4
Debary, FL 32713-5210
Phone
(386) 951-4538
Fax
(386) 259-3689
NPI assigned
Jan 24, 2007
Last updated
Nov 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME944332 FL Primary

Addresses

Primary practice location

2836 Enterprise Rd
Suite #4
Debary, FL 32713-5210

Mailing address

2836 Enterprise Rd
Suite # 4
Debary, FL 32713-5210
Phone (386) 951-4538

Other identifiers 2

IdentifierTypeStateIssuer
001062300MedicaidFL
05145OtherFLBCBS OF FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071204000655 FL Practitioner - Family Practice 9335238997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

2836 Enterprise Rd
Suite 4
Debary, FL 32713-5210
Phone (386) 951-4538

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME944332FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Family Care Inc Family Medicine CurrentSince Nov 9, 2007 Accepting new patients

Locations

2836 Enterprise Rd
Ste 4
Debary, FL 32713
Phone (386) 668-9600

978 International Pkwy
Ste 1440
Lake Mary, FL 32746
Phone (407) 391-3131

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1407901135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2836 ENTERPRISE RD",
            "address_2": "SUITE # 4",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327135210",
            "telephone_number": "386-951-4538",
            "fax_number": "386-259-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2836 ENTERPRISE RD",
            "address_2": "SUITE #4",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327135210",
            "telephone_number": "386-951-4538",
            "fax_number": "386-259-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MAGUED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME944332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001062300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "05145",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Debary, FL

Sources for this page

Verify at the official NPI Registry.