Omar A Ibrahimi, MD, PHD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

049530 Issued in CT

Practice address

2777 Summer St Ste 600
Stamford, CT 06905-4323

Phone

(203) 428-4440

Fax

(901) 221-4916

NPI assigned

Jun 15, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Dermatology

Education

New York University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Omar a Ibrahimi MD PHD LLCGroup PAC ID 0840448122, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Omar a Ibrahimi MD PHD LLC

  dba Connecticut Skin Institute

  • MOHS-Micrographic Surgery Physician
  • Stamford, CT
  • NPI 1013263847
  Medicare reassignment Care Compare group NPD Authorized official
• Center for Skin Surgery & Dermatology, PLLC

  • MOHS-Micrographic Surgery Physician
  • Glastonbury, CT
  • NPI 1407374481

  Dermatology

  NPD
• University of Connecticut Health Center

  • Clinical Medical Laboratory
  • Farmington, CT
  • NPI 1427031293
  NPD (past)
• University of Connecticut Health Center

  dba University Physicians

  • General Practice Physician
  • Farmington, CT
  • NPI 1720083769

  Dermatology

  NPD (past)
• Advanced Dermatology of New Jersey PC

  • Procedural Dermatology Physician
  • Ridgewood, NJ
  • NPI 1225362783
  NPD (past)
• Laser & Skin Surgery Medical Group Inc

  dba Laser & Skin Surgery Center of Northern California

  • Procedural Dermatology Physician
  • Sacramento, CA
  • NPI 1326150913
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1508061128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 SUMMER ST STE 600",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069054323",
            "telephone_number": "203-428-4440",
            "fax_number": "203-890-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 SUMMER ST STE 600",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069054323",
            "telephone_number": "203-428-4440",
            "fax_number": "901-221-4916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Commerce Park Ste C",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "CT",
            "postal_code": "064603513",
            "country_code": "US",
            "telephone_number": "203-428-4440",
            "fax_number": "901-221-4916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIMI",
        "first_name": "OMAR",
        "middle_name": "A",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "L-232692",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CT",
            "license": "049530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508061128",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Hwang, DDS
• Diane Hyatt, MSW
• I Got You Transportation LLC
• David C Ianacone II, MD
• Katherine Marie Ianni
• Ident at Harbor Point PC
• Ident PC
• Ilan Burstein DC, PC.
• Img Health of California PC
• Img Medical Group Mi, P.C.

• MOHS-Micrographic Surgery Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• MOHS-Micrographic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.