Individual provider Active NPI

Veronica Guirguis Ibrahim, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1639841083
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
221 Longwood Ave
Boston, MA 02115-5817
Phone
(617) 732-4918
NPI assigned
Oct 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

221 Longwood Ave
Boston, MA 02115-5817

Mailing address

221 Longwood Ave
Boston, MA 02115-5804
Phone (617) 732-4918

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814003260 MA Practitioner - Physician Assistant 4587051123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

221 Longwood Ave
Boston, MA 02115-5804
Phone (617) 732-5500

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

850 Boylston St
Chestnut Hill, MA 02467-2477
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

Interoperability endpoints

  • Direct secure messaging: guirguis.veronica.bwh@direct.partners.masshiway.net

Organizations & group practices 5

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 1

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": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1639841083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-732-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155817",
            "telephone_number": "617-732-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "VERONICA",
        "middle_name": "GUIRGUIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.