Individual provider Active NPI

Emad N. Ibrahim, MD

  • Hematology & Oncology Physician
  • Redlands, CA
National Provider Identifier
1598706129
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A51062 Issued in CA
Practice address
245 Terracina Blvd Ste 206
Redlands, CA 92373-4867
Phone
(909) 793-4336
Fax
(909) 793-3325
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A51062 CA Primary

Addresses

Primary practice location

245 Terracina Blvd Ste 206
Redlands, CA 92373-4867

Mailing address

PO Box 2200
Redlands, CA 92373-0722
Phone (909) 793-3311

Other practice location 1

245 Terracina Blvd Ste 208
Redlands, CA 92373-4851
Phone (909) 793-4336

Other identifiers 1

IdentifierTypeStateIssuer
00A510620MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20090102000141 CA Practitioner - Hematology/OncologyPractitioner - Medical Oncology 2062574874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Medical Oncology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

255 Terracina Blvd
Suite 104B
Redlands, CA 92373-4870
Phone (909) 793-4336

Hospital & facility affiliations

  • Redlands Community Hospital Hospital, Redlands, CA, CCN 050272
  • Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

Merit-based Incentive Payment System (MIPS)

Final score
26.54 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
88.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A51062CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 1, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 1, 2016 Accepting new patients
Emad Ibrahim, MD, Inc. CurrentSince May 15, 2016 Accepting new patients

Locations

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

245 Terracina Blvd
Ste 208
Redlands, CA 92373
Phone (909) 307-0126

245 Terracina Blvd
Ste 206
Redlands, CA 92373
Phone (909) 307-9824

255 Terracina Blvd
Ste 104B
Redlands, CA 92373
Phone (909) 793-3293

Organizations & group practices 4

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 2

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1598706129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730722",
            "telephone_number": "909-793-3311",
            "fax_number": "909-796-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 TERRACINA BLVD STE 206",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734867",
            "telephone_number": "909-793-4336",
            "fax_number": "909-793-3325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Terracina Blvd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923734851",
            "country_code": "US",
            "telephone_number": "909-793-4336",
            "fax_number": "909-793-3325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "EMAD",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A51062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A510620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.