Active NPI
Jonathan Dale Halley-Ibrahim, PA-C
- Physician Assistant
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5792
- Practice address
- 9321 W Thomas Rd Ste 202
Phoenix, AZ 85037-3392 - Phone
- (866) 974-2673
- Fax
- (866) 939-2673
- NPI assigned
- Sep 10, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 5792 | AZ | Primary |
Addresses
Primary practice location
9321 W Thomas Rd Ste 202
Phoenix, AZ 85037-3392
Mailing address
18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (669) 742-6738
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4815 E Carefree Hwy
Suite 124
Cave Creek, AZ 85331-4719
Phone (480) 626-0525
5920 W McDowell Rd
Phoenix, AZ 85035-4853
Phone (623) 245-0440
8101 N 19TH Ave
Suite a
Phoenix, AZ 85021-5161
Phone (602) 845-4505
914 N Scottsdale Rd
Suite 104
Tempe, AZ 85288-2116
Phone (480) 924-8382
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.65 of 100
- Quality
- 76.23
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.95
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5792 | AZ | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Orthopedic Research and Education, LLC | Physician Assistant | Current | Accepting new patients |
| Center for Orthopedic Research and Education LLC | Current | Accepting new patients | |
| Tri-City Express Care, PLLC | Current | Accepting new patients |
Locations
495 N Pinal Pkwy
Ste 106
Florence, AZ 85132
Phone (520) 568-0573
890 W Elliot Rd
Ste 103
Gilbert, AZ 85233
Phone (480) 241-7564
920 E Williams Field Rd
Ste 101
Gilbert, AZ 85295
Phone (480) 499-0201
415 N Val Vista Dr
Ste 101
Mesa, AZ 85213
Phone (480) 654-5661
9321 W Thomas Rd
Ste 202
Phoenix, AZ 85037
18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706
5259 W Indian School Rd
Ste 100
Phoenix, AZ 85031
Phone (623) 888-5101
18444 N 25th Ave
Ste 210
Phoenix, AZ 85023
Phone (669) 742-6738
10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311
7850 N Silverbell Rd
Ste 132
Tucson, AZ 85743
Phone (480) 500-2286
Interoperability endpoints
- jonathan.halleyibrahimpac.p1@direct.nextcare.nextgenshare.com
Organizations & group practices 6
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.
-
- Urgent Care Clinic/Center
- Tempe, AZ
- NPI 1114798071
-
dba The CORE Institute
- Orthopaedic Surgery Physician
- Phoenix, AZ
- NPI 1427095801
Physician Assistant
-
dba The Core Institute
- Durable Medical Equipment & Medical Supplies
- Flagstaff, AZ
- NPI 1063251056
-
dba FastMed Urgent Care
- Family Medicine Physician
- Mesa, AZ
- NPI 1649554940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1841691755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18444 N 25TH AVE STE 310",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850231266",
"telephone_number": "669-742-6738",
"fax_number": "669-392-6738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9321 W THOMAS RD STE 202",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850373392",
"telephone_number": "866-974-2673",
"fax_number": "866-939-2673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLEY-IBRAHIM",
"first_name": "JONATHAN",
"middle_name": "DALE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-10",
"last_updated": "2024-02-20",
"certification_date": "2024-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "5792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.