Individual provider Active NPI

Mahmoud Mohamed Ibrahim, MD

  • Pulmonary Disease Physician
  • Galveston, TX
National Provider Identifier
1649791567
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
BP10074404 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-1802
Phone
(409) 772-0750
Fax
(409) 747-0777
NPI assigned
Jun 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X BP10074404 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-1802

Mailing address

301 University Blvd
Galveston, TX 77555-0561
Phone (409) 772-0750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240805003926 TX Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0345787586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

4848 NE Stallings Dr
Suite 207
Nacogdoches, TX 75965-1266
Phone 93658560171266

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10074404TXMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Jul 24, 2024 Accepting new patients
BHS Physicians Network, Inc CurrentSince Jul 24, 2024 Accepting new patients
Harlem Past Accepting new patients

Locations

4848 NE Stallings Dr
Ste 207
Nacogdoches, TX 75965
Phone (936) 462-4214

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

Interoperability endpoints

  • Direct secure messaging: mahmoud.ibrahim.1@1438.direct.athenahealth.com

Organizations & group practices 3

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": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1649791567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550561",
            "telephone_number": "409-772-0750",
            "fax_number": "409-747-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551802",
            "telephone_number": "409-772-0750",
            "fax_number": "409-747-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MAHMOUD",
        "middle_name": "MOHAMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "BP10074404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.