Individual provider Active NPI

Christopher Ibanez, DO

  • Family Medicine Physician
  • Hamburg, PA
National Provider Identifier
1740772094
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT018483 Issued in PA
Practice address
700 Hawk Ridge Dr
Hamburg, PA 19526-9219
Phone
(610) 562-3066
Fax
(610) 562-3125
NPI assigned
Jun 2, 2018
Last updated
Dec 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT018483 PA Primary

Addresses

Primary practice location

700 Hawk Ridge Dr
Hamburg, PA 19526-9219

Mailing address

5265 Rockrose LN BLDG E25
Allentown, PA 18104-8249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT018483PAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1527897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1740772094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 ROCKROSE LN BLDG E25",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181048249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HAWK RIDGE DR",
            "city": "HAMBURG",
            "state": "PA",
            "postal_code": "195269219",
            "telephone_number": "610-562-3066",
            "fax_number": "610-562-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBANEZ",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-02",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT018483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, PA

Sources for this page

Verify at the official NPI Registry.