NPIMap

Individual provider Active NPI

Saman Ibrahim, M.D.

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1730451576
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2015008871 Issued in MO
Practice address
920 Twin Pine Dr
Saint Louis, MO 63131-4322
Phone
(312) 593-1560
NPI assigned
Feb 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 64127 TN
Diagnostic Radiology Physician 2085R0202X 2015008871 MO Primary

Addresses

Primary practice location

920 Twin Pine Dr
Saint Louis, MO 63131-4322

Mailing address

920 Twin Pine Dr
Saint Louis, MO 63131-4322
Phone (312) 593-1560

Other identifiers 1

IdentifierTypeStateIssuer
Q061630MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150814013913 MO Practitioner - Diagnostic Radiology 2365607744 Reassigns benefits to 8 organizations
I20230125000247 TN Practitioner - Diagnostic Radiology 2365607744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rush Medical College of Rush University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians
Memphis Physicians Radiological Group PCGroup PAC ID 9830123736, 79 clinicians
USA Radiology Management Solutions LLCGroup PAC ID 3577780337, 26 clinicians
Savannah Chatham Imaging LLCGroup PAC ID 6800890245, 32 clinicians
USA Radiology of Pennsylvania LLCGroup PAC ID 0345594388, 22 clinicians

Practice addresses (Care Compare)

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

1301 Medical Ctr Dr
Nashville, TN 37232-0028
Phone (615) 322-5000

5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-2191

920 Twin Pine Dr
Des Peres, MO 63131-4322
Phone (314) 238-5260

946 E Reed
Hayti, MO 63851
Phone (314) 821-8055

Hospital & facility affiliations

  • West Tennessee Healthcare Henry County Hospital Hospital, Paris, TN, CCN 440132
  • Lecom Medical Center and Behavioral Health Pav Hospital, Erie, PA, CCN 390198
  • Lecom Health Corry Memorial Hospital Hospital, Corry, PA, CCN 391308
  • Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017
  • Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015008871MOMDDiagnostic Radiology Physician
64127TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pemiscot County Memorial Hospital Current Accepting new patients
USA Radiology of Pennsylvania, LLC CurrentSince Oct 1, 2020 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Feb 1, 2021 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Feb 1, 2021 Accepting new patients
Missouri Delta Medical Center CurrentSince Mar 1, 2025 Accepting new patients
Missouri Delta Medical Center CurrentSince Mar 1, 2025 Accepting new patients
Savannah Chatham Imaging LLC Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Feb 1, 2021 Accepting new patients
Memphis Physicians Radiological Group PC Diagnostic Radiology CurrentSince Dec 1, 2022 Accepting new patients
USA Radiology Management Solutions LLC Diagnostic Radiology CurrentSince Oct 1, 2020 Accepting new patients
Vanderbilt University Medical Center Diagnostic Radiology CurrentSince Jul 26, 2023 Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

Dept AT 40379
Atlanta, GA 31192

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

10 Little Brook Rd
West Wareham, MA 02576

16091 Swingley Ridge Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 728-2222

946 E Reed St
Hayti, MO 63851
Phone (573) 359-3408

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

751 Liberty St
Meadville, PA 16335
Phone (814) 333-5081

406 W Oak St
Titusville, PA 16354
Phone (814) 827-1851

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

1301 Medical Center Dr
Nashville, TN 37232
Phone (615) 343-4882

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

Organizations & group practices 11

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1730451576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 TWIN PINE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631314322",
            "telephone_number": "312-593-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 TWIN PINE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631314322",
            "telephone_number": "312-593-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "SAMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "64127",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2015008871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q061630",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.