Individual provider Active NPI

Dina Ibrahim, DO

  • Emergency Medicine Physician
  • Middletown, NY
National Provider Identifier
1649762618
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
309732-01 Issued in NY
Practice address
707 E Main St
Middletown, NY 10940-2650
Phone
(845) 333-6333
Fax
(845) 333-7342
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 309732-01 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940-2650

Mailing address

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-6333

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
I20210611000987 NY Practitioner - Emergency Medicine 0648670786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Emergency Medical Services PCGroup PAC ID 4981503513, 138 clinicians

Practice addresses (Care Compare)

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.85 of 100Reported as group
Quality
79.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309732-01NYMDEmergency Medicine Physician
309732NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Island Emergency Medical Services, P.C. Emergency Medicine CurrentSince Jun 7, 2023 Accepting new patients

Locations

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

103 Sitterly Rd
Halfmoon, NY 12065
Phone (518) 579-2700

200 Harborside Dr
Schenectady, NY 12305
Phone (518) 881-4470

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1649762618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-6333",
            "fax_number": "845-333-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-6333",
            "fax_number": "845-333-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "DINA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "309732-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.