Active NPI
Amir E Ibrahim, MD
- Surgery Physician
- Boston, MA
National Provider Identifier
1518215417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- L-252951
- Practice address
- Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114 - Phone
- (617) 726-3712
- NPI assigned
- Aug 27, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | L-252951 | MA | Primary |
Addresses
Primary practice location
Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Mailing address
Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 726-3712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130123000338 | MA | Order and Referring Only - General Surgery | 3577716604 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-252951 | MA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346025600000",
"number": "1518215417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MASSACHUSETTS GENERAL HOSPITAL",
"address_2": "55 FRUIT ST.",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-3712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MASSACHUSETTS GENERAL HOSPITAL",
"address_2": "55 FRUIT ST.",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-3712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "AMIR",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-27",
"last_updated": "2012-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "L-252951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.