Ibrahim Elkhawas

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

289311 Issued in MA

Practice address

2100 Dorchester Ave RM 7039
Boston, MA 02124-5615

Phone

(502) 232-5956

NPI assigned

Jun 10, 2021

Last updated

Jun 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1740858380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CROWN DR UNIT 103",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE RM 7039",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "502-232-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKHAWAS",
        "first_name": "IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "289311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Medical DME LLC
• Christopher M Elitt, MD, PHD
• Elizabeth Lasalvia MD LLC
• Seleem Elkadi
• Safwan Elkhatib, MD, PHD
• Claudette Elkhoury, DMD
• Eileen Elkies, OT
• Rachel Elkin, MD
• Burak Elkiran, M.D
• Jacob Matt Elkon, MD

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.