Individual provider Active NPI

Ibrahim Diakhate, CRNP

  • Nurse Practitioner
  • Lancaster, PA
National Provider Identifier
1679441604
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP034381 Issued in PA
Practice address
17 Kennedy St
Lancaster, PA 17602-4098
Phone
(877) 564-3627
NPI assigned
Oct 29, 2025
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP034381 PA Primary

Addresses

Primary practice location

17 Kennedy St
Lancaster, PA 17602-4098

Mailing address

837 Hilton Dr
Lancaster, PA 17603-5835
Phone (267) 928-5058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260103510153 PA Practitioner - Nurse Practitioner 8628564218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

424 Church St
Nashville, TN 37219-2301

837 Hilton Dr
Lancaster, PA 17603-5835

909 Ridgebrook Rd
Suite 300
Sparks, MD 21152-9474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP034381PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus Multi-Specialty CurrentSince Dec 1, 2025 Accepting new patients
Consonant Healing Medical Associates Multi-Specialty CurrentSince Dec 11, 2025 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

909 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (443) 483-9300

905 Tower Rd
#3188
Bristol, PA 19007
Phone (215) 785-3201

100 S Juniper St
Fl 3
Philadelphia, PA 19107
Phone (267) 999-9534

50 N Pennsylvania Ave
#V
Wilkes Barre, PA 18701

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1679441604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 HILTON DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176035835",
            "telephone_number": "267-928-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 KENNEDY ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176024098",
            "telephone_number": "877-564-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAKHATE",
        "first_name": "IBRAHIM",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP034381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.