Individual provider Active NPI

Nagwa Ibrahim, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1790297638
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008651 Issued in NY
Practice address
5171 Kings PLZ
Brooklyn, NY 11234-5218
Phone
(718) 951-9800
Fax
(718) 252-3736
NPI assigned
Nov 1, 2017
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008651 NY Primary

Addresses

Primary practice location

5171 Kings PLZ
Brooklyn, NY 11234-5218

Mailing address

1 Ritz PL
Lindenhurst, NY 11757-1833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191216000498 NY Practitioner - Optometry 1153754643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Optometry PCGroup PAC ID 8022425966, 2 clinicians

Practice addresses (Care Compare)

5171 Kings PLZ
Brooklyn, NY 11234-5218
Phone (718) 951-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008651NYMDOptometrist
008651NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
General Optometry PC Optometrist CurrentSince Jun 1, 2021 Accepting new patients
Mendelsohn Medical, PLLC Past Accepting new patients
Steven I Goodman OD PC Optometrist PastSince Oct 16, 2008 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1790297638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RITZ PL",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117571833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 KINGS PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345218",
            "telephone_number": "718-951-9800",
            "fax_number": "718-252-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "NAGWA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2022-11-09",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.