Ghassan Jerjous Ibrahim, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

58135 Issued in AZ

Practice address

424 S 56TH St Ste 120
Phoenix, AZ 85034-2177

Phone

(602) 685-5166

Fax

(602) 685-5325

NPI assigned

May 5, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Pathology

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pathology Specialist of Arizona, LLPGroup PAC ID 4789583188, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
• Banner Payson Medical Center Hospital, Payson, AZ, CCN 031318

Merit-based Incentive Payment System (MIPS)

Final score

78.75 of 100Reported as group

Quality

75

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Pathology Specialist of Arizona, LLP

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1174503999
  Medicare reassignment Care Compare group NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708
  NPD (past)

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

• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation
• Banner Health

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340
  Care Compare affiliation

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1740456136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850802210",
            "telephone_number": "623-266-7770",
            "fax_number": "623-322-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 S 56TH ST STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342177",
            "telephone_number": "602-685-5166",
            "fax_number": "602-685-5325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 NJ 72",
            "address_purpose": "LOCATION",
            "city": "Manahawkin",
            "state": "NJ",
            "postal_code": "080500805",
            "country_code": "US",
            "telephone_number": "609-978-8900 x3055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "GHASSAN",
        "middle_name": "JERJOUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA08776200",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "58135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Ibragimov, M.D.
• Ahmad Ibrahim Ibrahim, OD
• Asad Ibrahim
• Aseel Hany Ibrahim
• Fatima Ibrahim
• Hiba Ibrahim, M.D.
• Luma Ibrahim
• Rawan Ibrahim
• Samer Ibrahim
• Steve Ibrahim, D.O.

• Anatomic Pathology & Clinical Pathology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Anatomic Pathology & Clinical Pathology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.
• 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.