Individual provider Active NPI

Lauren Ibrahim, M.D.

  • Infectious Disease Physician
  • Hartford, CT
National Provider Identifier
1790944239
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
53494 Issued in CT
Practice address
1000 Asylum Ave Ste 2112
St. Francis Medical Group, Inc
Hartford, CT 06105
Phone
(860) 714-4903
NPI assigned
Jun 9, 2008
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD449171 PA
Infectious Disease Physician 207RI0200X 53494 CT Primary

Addresses

Primary practice location

1000 Asylum Ave Ste 2112
St. Francis Medical Group, Inc
Hartford, CT 06105

Mailing address

1000 Asylum Ave Ste 2112
Saint Francis Medical Group, Inc
Hartford, CT 06105-1719
Phone (860) 714-5895

Other practice location 1

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-5895

Other names 1

  • Dr. Lauren Bertelle Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address librahim66929@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20141022000122 CT Practitioner - Infectious Disease 7810130630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 Asylum Ave
Hartford, CT 06105-1702

114 Woodland St
Hartford, CT 06105-1208

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Nov 3, 2014 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Nov 3, 2014 Accepting new patients
Saint Francis Care Medical Group, PC Past Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

1000 Asylum Ave
Ste 2112
Hartford, CT 06105
Phone (860) 714-4749

1000 Asylum Ave
Ste 4304
Hartford, CT 06105
Phone (860) 522-3711

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

Interoperability endpoints

  • Direct secure messaging: librahim2389376@direct.trinity-health.org

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1790944239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE STE 2112",
            "address_2": "SAINT FRANCIS MEDICAL GROUP, INC",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051719",
            "telephone_number": "860-714-5895",
            "fax_number": "860-714-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE STE 2112",
            "address_2": "ST. FRANCIS MEDICAL GROUP, INC",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-714-4903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Woodland St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051208",
            "country_code": "US",
            "telephone_number": "860-714-5895",
            "fax_number": "860-714-5417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD449171",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CT",
            "license": "53494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "librahim66929@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health of New England Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1000 Asylum Ave Ste 4304",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061051704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "BERTELLE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.