Abrahim Imam

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO.3848 Issued in AL

Practice address

1665 S Green St
Tupelo, MS 38804-6556

Phone

(662) 377-2189

Fax

(662) 377-2667

NPI assigned

Apr 5, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osama Elshazly MD PAGroup PAC ID 5294839098, 2 clinicians

Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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 Medicine Services of FL, LLC

  • Hospitalist Physician
  • Aventura, FL
  • NPI 1710684857
  Medicare reassignment Care Compare group NPD
• Osama Elshazly MD PA

  • Internal Medicine Physician
  • Panama City, FL
  • NPI 1962514299
  Medicare reassignment Care Compare group NPD
• Abrahim Imam D.O.

  • Family Medicine Physician
  • Panama City, FL
  • NPI 1366392573
  NPD Authorized official
• Ibrahim Imam DO Inc

  • Adult Medicine Physician
  • Panama City, FL
  • NPI 1841124070
  NPD Authorized official

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

• Bay Hospital, Inc

  • General Acute Care Hospital
  • Panama City, FL
  • NPI 1699721589
  Care Compare affiliation

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1427637644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMAM",
        "first_name": "ABRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.3848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atif Ibrahim
• Omer Mohamed Ali Ibrahim, BDS, DDS
• Wanda Ikeda, ACNP
• Illuminated Life Counseling LLC
• Imaging Center at Gloster Creek Village PLLC
• Laura Akugbe Imarhiagbe, M.D.
• Malinda Ingram, FNP
• Laura Kate Inman
• Innovative Prosthetic Care Tupelo LLC
• Thomas A Ireland, M.D.

• Family Medicine Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.