Organization Active NPI

The Practice OB/GYN PC

  • Obstetrics & Gynecology Physician
  • Methuen, MA
National Provider Identifier
1619419082
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
THE PRACTICE OB/GYN PC
Practice address
60 East St Ste 1100
Methuen, MA 01844-4547
Phone
(978) 458-8855
Fax
(978) 458-8866
NPI assigned
Nov 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Dr. Ibrahim Joulak, M.D.
Title
Owner
Phone
(978) 458-8855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

60 East St Ste 1100
Methuen, MA 01844-4547

Mailing address

60 East St Ste 1100
Methuen, MA 01844-4547
Phone (978) 458-8855

Other identifiers 2

IdentifierTypeStateIssuer
110119473AMedicaidMA
S100357282OtherMAMEDICARE ID

National Provider Directory

National Provider Directory

Locations

275 Varnum Ave
Ste 103
Lowell, MA 01854
Phone (978) 458-8855

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1619419082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 EAST ST STE 1100",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444547",
            "telephone_number": "978-458-8855",
            "fax_number": "978-458-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 EAST ST STE 1100",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444547",
            "telephone_number": "978-458-8855",
            "fax_number": "978-458-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PRACTICE OB/GYN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "JOULAK",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-458-8855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110119473A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "S100357282",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.