Individual provider Active NPI

Christopher Nino Ibabao, MD

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1639798838
Registry record updated Jun 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
75 W End Ave Apt P16B
New York, NY 10023-7875
Phone
(716) 720-0161
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

75 W End Ave Apt P16B
New York, NY 10023-7875

Mailing address

75 W End Ave Apt P16B
New York, NY 10023-7875
Phone (716) 720-0161

Other practice location 1

515 W 59th St Apt 16F
New York, NY 10019-1041
Phone (716) 720-0161

Other practice location 2

100 Woods Rd
Valhalla, NY 10595-1530
Phone (716) 720-0161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20251107003474 NY Practitioner - Diagnostic Radiology 6204326143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Johns Hopkins University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates IncGroup PAC ID 9436045259, 57 clinicians

Practice addresses (Care Compare)

301 W 57TH St
Apt 45B
New York, NY 10019-3180
Phone (303) 914-8800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates Inc CurrentSince Nov 1, 2025 Accepting new patients

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 6

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622937600000",
    "number": "1639798838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 W END AVE APT P16B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237875",
            "telephone_number": "716-720-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W END AVE APT P16B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237875",
            "telephone_number": "716-720-0161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 W 59th St Apt 16F",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191041",
            "country_code": "US",
            "telephone_number": "716-720-0161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "716-720-0161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBABAO",
        "first_name": "CHRISTOPHER",
        "middle_name": "NINO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2021-06-06",
        "certification_date": "2021-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.