Kristen Alyssa Ibrahim

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

125 Maiden LN RM 6B
New York, NY 10038-4715

Phone

(212) 480-9500

NPI assigned

May 11, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Vivify Medical PLLC

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1639908973
  Medicare reassignment NPD
• Amnon Beniaminovitz MD PC

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1669142055
  NPD

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1821788951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MAIDEN LN RM 6B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384715",
            "telephone_number": "212-480-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MAIDEN LN RM 6B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384715",
            "telephone_number": "212-480-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "KRISTEN",
        "middle_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Halah Ibrahim, MD
• Huda Ibrahim
• Ibtisam Abbas Elhaj Ibrahim, M.D.
• Ihab I Ibrahim, MD
• Khalid Ibrahim, RPH
• Kristin Ibrahim
• Lena Ibrahim, PHARMD
• Mina Aziz Ibrahim, M.D.
• Mohammed Nurudeen Ibrahim, PHD
• Nadwa Ibrahim, MD

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.