NPIMap

Individual provider Active NPI

Ibrahim George Zabaneh, MD

  • Family Medicine Physician
  • Hobart, IN
National Provider Identifier
1578555496
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01033620 Issued in IN
Practice address
1400 S Lake Park Ave
Ste 500
Hobart, IN 46342-6636
Phone
(219) 942-7299
Fax
(219) 947-6624
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2008

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 01033620 IN Primary

Addresses

Primary practice location

1400 S Lake Park Ave
Ste 500
Hobart, IN 46342-6636

Mailing address

1400 S Lake Park Ave
Ste 500
Hobart, IN 46342-6636
Phone (219) 942-7299

Other identifiers 3

IdentifierTypeStateIssuer
100208860AMedicaidIN
000000078875OtherINBLUE CROSS BLUE SHIELD
080157210OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080819000750 IN Practitioner - Family Practice 4486729845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

1400 S Lake Park Ave
Hobart, IN 46342-6790

1451 Morthland Dr
Valparaiso, IN 46385-6360

9130 Columbia Ave
Munster, IN 46321-2932

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
St. Mary Medical Center Inc Family Medicine Past Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1400 S Lake Park Ave
Ste 500
Hobart, IN 46342
Phone (219) 942-7299

164 Bracken Pkwy
Hobart, IN 46342
Phone (219) 942-1145

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

9660 Wicker Ave
Saint John, IN 46373
Phone (219) 226-2203

Interoperability endpoints

  • Direct secure messaging: izabaneh1527@ssdirect.comhs.org

Organizations & group practices 2

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 & 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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1578555496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S LAKE PARK AVE",
            "address_2": "STE 500",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426636",
            "telephone_number": "219-942-7299",
            "fax_number": "219-947-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S LAKE PARK AVE",
            "address_2": "STE 500",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426636",
            "telephone_number": "219-942-7299",
            "fax_number": "219-947-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZABANEH",
        "first_name": "IBRAHIM",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01033620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100208860A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000078875",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080157210",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobart, IN

Sources for this page

Verify at the official NPI Registry.