Individual provider Active NPI

Hasib Ibnerasa, M.D.

  • Internal Medicine Physician
  • Lake Mary, FL
National Provider Identifier
1821056516
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME76638 Issued in FL
Practice address
2500 W Lake Mary Blvd
Suite 101
Lake Mary, FL 32746-3501
Phone
(407) 936-0976
Fax
(407) 936-0977
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME76638 FL Primary

Addresses

Primary practice location

2500 W Lake Mary Blvd
Suite 101
Lake Mary, FL 32746-3501

Mailing address

PO Box 953457
Lake Mary, FL 32795-3457
Phone (407) 936-0976

Other identifiers 1

IdentifierTypeStateIssuer
262539300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051028000154 FL Practitioner - Internal Medicine 7416983895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4250 NW 5TH St
Plantation, FL 33317-2160
Phone (954) 587-3296

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Internal Medicine Current Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Sep 8, 2014 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Sep 8, 2014 Accepting new patients

Locations

806 S Douglas Rd
Ste 820
Coral Gables, FL 33134

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

4250 NW 5th St
Plantation, FL 33317
Phone (954) 240-0091

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1821056516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 953457",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327953457",
            "telephone_number": "407-936-0976",
            "fax_number": "407-936-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W LAKE MARY BLVD",
            "address_2": "SUITE 101",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463501",
            "telephone_number": "407-936-0976",
            "fax_number": "407-936-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBNERASA",
        "first_name": "HASIB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME76638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262539300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.