Individual provider Active NPI

Jonathan Dale Halley-Ibrahim, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1841691755
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5792 Issued in AZ
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

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141118002426 AZ Practitioner - Physician Assistant 9830311349 Reassigns benefits to 4 organizations

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
Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

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 100Reported as group
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

LicenseStateTypeSpecialty
5792AZMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education, LLC Physician Assistant CurrentSince Nov 22, 2021 Accepting new patients
Center for Orthopedic Research and Education LLC CurrentSince Nov 22, 2021 Accepting new patients
Tri-City Express Care, PLLC CurrentSince Jan 5, 2018 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.