Jack Ibrahim, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9518T Issued in TX

Practice address

398 E FM 1382
Cedar Hill, TX 75104-6024

Phone

(909) 919-6044

NPI assigned

Jul 3, 2018

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 TX, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment NPD
• Meredith Walton OD, Optometric Corporation

  • Optometrist
  • San Diego, CA
  • NPI 1801317672
  Medicare reassignment NPD
• Warren Eye Associates

  • Optometrist
  • Kyle, TX
  • NPI 1134306582
  NPD (past)
• Heights Optometry

  • Optometrist
  • San Diego, CA
  • NPI 1386034163
  NPD (past)

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1760978571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 E FM 1382",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046024",
            "telephone_number": "909-919-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 E FM 1382",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046024",
            "telephone_number": "909-919-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9518T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Kailone Hughes, LCSW
• Leslie S Hunt, MS, CCC-SLP
• Daniele Hunter
• Hiba Hussain
• I.M. Resilient Counseling and Consulting PLLC
• Icon Legacy Group LLC
• Ikids Pediatric Dentistry Cedar Hill, PLLC
• Imagemaker Inc
• Imi Home Health Care LLC
• Infinite Care Family Services LLC

• Optometrist in Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.