Nashaat Botrous Ibraheim, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K4089 Issued in TX

Practice address

12121 Richmond Ave
Suite 412
Houston, TX 77082-2437

Phone

(281) 558-5656

Fax

(281) 558-5667

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Houston Healthcare West Hospital, Houston, TX, CCN 450644

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
• Direct secure messaging: nashaat.ibraheim.1@8042.direct.athenahealth.com

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.

• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment Care Compare group NPD
• Privia Medical Group Gulf Coast PLLC

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1457167033
  NPD
• C H Wilkinson Physician Network

  • Family Medicine Physician
  • Irving, TX
  • NPI 1457382947
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Chca West Houston L P

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1275580938
  Care Compare affiliation

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1659594752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "SUITE 412",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822437",
            "telephone_number": "281-558-5656",
            "fax_number": "281-558-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "SUITE 412",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822437",
            "telephone_number": "281-558-5656",
            "fax_number": "281-558-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHEIM",
        "first_name": "NASHAAT",
        "middle_name": "BOTROUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K4089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157198601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ibis Healthcare, Inc.
• Walid Ibn Essayed, M.D.
• Ibn Sina Community Clinic Pharmacy
• Ibn Sina Foundation
• Ibn Sina Foundation
• Ibrahim Garcia-Mowatt M.D., P.a.
• Ibrahim Sylla
• Ahmed Ibrahim, M.D.
• Aisha Ibrahim
• Amal Mohamed Moustafa Ibrahim I, MD

• Family Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.