Mahmud Ibrahim, M.D.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

25MA09258600 Issued in NJ

Practice address

555 Route 18 Ste 202
East Brunswick, NJ 08816-3727

Phone

(732) 955-9139

Fax

(732) 387-8594

NPI assigned

Jun 23, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ascension Spine, Pain, and Sports Medicine

  • Interventional Pain Medicine Physician
  • East Brunswick, NJ
  • NPI 1124948856
  NPD Authorized official
• Revive Spine and Pain Center

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Marlton, NJ
  • NPI 1457896003
  NPD (past)

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1669633558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 ROUTE 18 STE 202",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163727",
            "telephone_number": "732-955-9139",
            "fax_number": "732-387-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 ROUTE 18 STE 202",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163727",
            "telephone_number": "732-955-9139",
            "fax_number": "732-387-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MAHMUD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "25MA09258600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Iacullo, MA BCBA
• Patricia N Iannotta, MD
• Claire Ibrahim
• Gehan Ibrahim, MD
• George Ibrahim, PT
• Arianna Elizabeth Illa, LSW
• Image Diagnostic Services
• Infectious Diseases Specialist of NJ
• Inga Friedman MD PC
• Kathleen Marie Inneo, DPT

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.