NPIMap

Individual provider Active NPI

John-Mina Ibrahim, M.D.

  • Emergency Medicine Physician
  • Detroit, MI
National Provider Identifier
1740484369
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301086042 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-1553
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301086042 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

1598 Old Chatham Dr
Bloomfield Hills, MI 48304-1040
Phone (248) 703-5659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081007000615 MI Practitioner - Emergency Medicine 6103994934 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Observation Physicians PLLCGroup PAC ID 3577603604, 138 clinicians

Practice addresses (Care Compare)

1101 W University Dr
Rochester, MI 48307-1863
Phone (248) 652-5000

47601 Grand River Ave
Novi, MI 48374-1233
Phone (248) 465-4210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301086042MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Observation Physicians PLLC CurrentSince Aug 2, 2012 Accepting new patients
Scheurer Hospital CurrentSince Aug 1, 2025 Accepting new patients
Independent Emergency Physicians, P.C. CurrentSince Jul 1, 2008 Accepting new patients
Scheurer Hospital Current Accepting new patients
Scheurer Hospital Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients

Locations

36750 26 Mile Rd
Chesterfield, MI 48047
Phone (586) 879-2000

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

4100 S River Rd
East China, MI 48054
Phone (810) 329-6677

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

17700 23 Mile Rd
Macomb, MI 48044
Phone (586) 416-7500

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

170 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-3223

108 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-7301

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: jibrahim181607@direct.covenanthealthcare.com
  • Direct secure messaging: jibrahim1132859@direct.hfhs.org

Organizations & group practices 5

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740484369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 OLD CHATHAM DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041040",
            "telephone_number": "248-703-5659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "JOHN-MINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301086042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.