Ibrahim Tawfiq Fakhouri, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14038 Issued in NV

Practice address

861 Coronado Center Dr Ste 220
Henderson, NV 89052-3992

Phone

(702) 933-1485

Fax

(702) 933-1490

NPI assigned

Jun 10, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Abraham T Fakhouri MDGroup PAC ID 8628337201, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ibrahim.fakhouri.1@23484.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.

• Abraham T. Fakhouri, M.D.

  • Family Medicine Physician
  • Henderson, NV
  • NPI 1730691890
  Medicare reassignment Care Compare group
• Dignity Health

  dba St. Rose Dominican Hospital, Rose de Lima Campus

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1447393152
  NPD (past)
• Inpatient Consultants of Nevada, Inc. a Medical Corporation

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1821041070
  NPD (past)

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1720248206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 CORONADO CENTER DR STE 220",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523992",
            "telephone_number": "702-933-1485",
            "fax_number": "702-933-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 CORONADO CENTER DR STE 220",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523992",
            "telephone_number": "702-933-1485",
            "fax_number": "702-933-1490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Green Valley Pkwy",
            "address_2": "Suite 239",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890746391",
            "country_code": "US",
            "telephone_number": "702-933-1485",
            "fax_number": "702-933-1490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAKHOURI",
        "first_name": "IBRAHIM",
        "middle_name": "TAWFIQ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2010-0739",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 109981",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD443512",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "14038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shauwnna Fairley
• Firoozeh Faiz
• Mary Fajardo
• Reyleth Joy Basa Fajardo, APRN
• Corazon B Fajota
• Niloufar Fakhrachi
• Candice Falcon
• Amy M Falcone-Wharton, MD
• Camille A Falkner, MD
• Sophia Fallander

• Family Medicine Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.