Individual provider Active NPI

Ishaq O Ibrahim, MD

  • Orthopaedic Trauma Physician
  • Boston, MA
National Provider Identifier
1871975003
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
1013936 Issued in MA
Practice address
330 Brookline Ave
Stoneman 10
Boston, MA 02215-5400
Phone
(617) 667-3940
NPI assigned
Jun 24, 2015
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 1013936 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Stoneman 10
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Stoneman 10
Boston, MA 02215-5400
Phone (617) 667-3940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210917000667 NY Practitioner - Orthopedic Surgery 5496062556 Reassigns benefits to 3 organizations
I20241209004139 MA Practitioner - Orthopedic Surgery 5496062556 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rush Medical College of Rush University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1013936MAMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2024 Accepting new patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
University Physicians of Brooklyn, Inc. Orthopaedic Surgery CurrentSince Sep 1, 2021 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Orthopaedic Surgery CurrentSince Sep 1, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients
New England Baptist Medical Associates, Inc. Orthopaedic Surgery Past Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
#10
Boston, MA 02215
Phone (617) 667-2295

330 Brookline Ave
Ste 10
Boston, MA 02215
Phone (617) 667-3940

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Interoperability endpoints

  • Direct secure messaging: iibrahim1619021@nychhc.direct-ci.com
  • Direct secure messaging: ishaq.ibrahim.1@438.direct.athenahealth.com
  • Direct secure messaging: ishaqibrahim@sunydmc.allscriptsdirect.net

Organizations & group practices 14

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.

View all 14

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1871975003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "STONEMAN 10",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "STONEMAN 10",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "ISHAQ",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MA",
            "license": "1013936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.