Benyamin Y Ebrahim, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

49780 Issued in TN

Practice address

522 Bell Rd
Antioch Eye Care Center, Physician & Surgeon, PLLC
Antioch, TN 37013-2002

Phone

(615) 361-7266

NPI assigned

May 28, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Ophthalmology

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Antioch Eye Care Center, Physician and Surgeon, PLLCGroup PAC ID 4688996531, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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.

• Antioch Eye Care Center, Physician & Surgeon, PLLC

  • Ophthalmology Physician
  • Antioch, TN
  • NPI 1629477831
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1508024415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 BELL RD",
            "address_2": "ANTIOCH EYE CARE CENTER, PHYSICIAN & SURGEON, PLLC",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132002",
            "telephone_number": "615-361-7266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 BELL RD",
            "address_2": "ANTIOCH EYE CARE CENTER, PHYSICIAN & SURGEON, PLLC",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132002",
            "telephone_number": "615-361-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIM",
        "first_name": "BENYAMIN",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "49780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1531656",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eagle Eye Transportation LLC
• Eagle Eyecare PLLC
• Early Bird Transportation LLC
• Jessica Dixon Easter
• Ebenezer Home of Tennessee, Inc.
• Sheredrick Anthony Edmundson
• Cynthia Ann Edwards, DDS
• Efficient Supports,Inc.
• Elite Mobility LLC
• Dawn Dee Elson, B.PH.

• Ophthalmology Physician in Antioch, TN
• Providers in Antioch, TN by specialty
• Ophthalmology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.