Individual provider Active NPI

Hisham Abdellah Osman Ibrahim, MD

  • Interventional Cardiology Physician
  • Iowa City, IA
National Provider Identifier
1578935268
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
V5549 Issued in TX
Practice address
200 Hawkins Dr
Iowa City, IA 52242
Phone
(319) 356-4019
Fax
(319) 353-8073
NPI assigned
Oct 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-45168 IA
Hospitalist Physician 208M00000X MD-45168 IA
Interventional Cardiology Physician 207RI0011X V5549 TX Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-4019

Other practice location 1

753 Classon Ave
APARTMENT 1c
Brooklyn, NY 11238-4647
Phone (929) 500-4402

Other practice location 2

1783 Troup Hwy
Tyler, TX 75701-5869
Phone (903) 595-2283

Other practice location 3

2026 S Jackson St
Jacksonville, TX 75766-5822
Phone (903) 586-5678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250129000117 TX Practitioner - Interventional Cardiology 8921354101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

105 -II Medical PLZ
Christus Trinity Clinic
Sulphur Springs, TX 75482-2105
Phone (903) 885-5439

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 595-2283

115 Airport Rd
Sulphur Springs, TX 75482-2105
Phone (903) 885-7671

127 Medical Dr
Palestine, TX 75801-4781
Phone (903) 723-3300

1302 N Pacific St
Christus Trinity Clinic
Mineola, TX 75773-1022
Phone (903) 569-5383

1505 S Palestine St
Athens, TX 75751-8950
Phone (903) 675-6800

1505 State Hwy 19 S
Christus Trinity Clinic
Athens, TX 75751-8950
Phone (903) 675-1725

1783 Troup Hwy
Tyler, TX 75701-5869
Phone (903) 595-2283

18780 Interstate 20
Canton, TX 75103-3593
Phone (903) 567-4841

20208 State Hwy 155 S
Christus Trinity Clinic
Flint, TX 75762-5600
Phone (903) 825-6222

2026 S Jackson St
Jacksonville, TX 75766-5822
Phone (903) 541-4599

3201 S Loop
Palestine, TX 75801-6901

3203 S Main St
Christus Trinity Clinic
Lindale, TX 75771-7727
Phone (903) 266-4000

3593 E Grande Blvd
Christus Trinity Clinic
Tyler, TX 75707-1400
Phone (903) 839-2585

3802 Manhatton Dr
Tyler, TX 75701-9451
Phone (903) 509-8888

520 Douglas Blvd
Tyler, TX 75702-8307
Phone (903) 593-1721

5321 S FM
14 Christus Trinity Clinic
Holly Lake Ranch, TX 75765-4839
Phone (903) 769-2990

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

700 S Fleishel Ave
Tyler, TX 75701-2014
Phone (903) 606-5600

719 W Coke Rd
Christus Trinity Clinic
Winnsboro, TX 75494-3011
Phone (903) 342-5227

800 E Dawson St
Christus Trinity Clinic
Tyler, TX 75701-2036
Phone (903) 510-1186

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-45168IAMDInternal Medicine Physician
V5549TXMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Mar 24, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Mar 24, 2025 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Nov 30, 2025 Accepting new patients

Locations

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

1783 Troup Hwy
Tyler, TX 75701
Phone 90359522832057

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: hibrahim538996@christushealth.direct-ci.net

Organizations & group practices 3

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 5

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": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1578935268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-4019",
            "fax_number": "319-353-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52242",
            "telephone_number": "319-356-4019",
            "fax_number": "319-353-8073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "753 Classon Ave",
            "address_2": "APARTMENT 1c",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112384647",
            "country_code": "US",
            "telephone_number": "929-500-4402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1783 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757015869",
            "country_code": "US",
            "telephone_number": "903-595-2283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2026 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "757665822",
            "country_code": "US",
            "telephone_number": "903-586-5678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "HISHAM",
        "middle_name": "ABDELLAH OSMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD-45168",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "MD-45168",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "V5549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.