Active NPI
Ishaq O Ibrahim, MD
- Orthopaedic Trauma Physician
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Trauma Physician
- License
- 1013936
- Practice address
- 330 Brookline Ave
Stoneman 10
Boston, MA 02215-5400 - Phone
- (617) 667-3940
- NPI assigned
- Jun 24, 2015
- Last updated
- Sep 20, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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 Inc
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
- Beth Israel Deaconess Medical Center
- Beth Israel Deaconess Hospital - Needham
- Beth Israel Deaconess Hospital Plymouth
- Cape Cod Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1013936 | MA | MD | Orthopaedic Trauma Physician |
Practice roles
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
- iibrahim1619021@nychhc.direct-ci.com
- ishaq.ibrahim.1@438.direct.athenahealth.com
- 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.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1548202641
-
- Internal Medicine Physician
- Boston, MA
- NPI 1194765438
-
dba Orthopedic Surgery - HMFP at BIDMC
- Orthopaedic Surgery Physician
- Boston, MA
- NPI 1972544591
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- Family Medicine Physician
- Brooklyn, NY
- NPI 1366506271
-
- General Practice Physician
- New York, NY
- NPI 1487957692
-
- Ambulance
- Boston, MA
- NPI 1518600501
-
dba Emergency Medicine - HMFP at BIDMC
- Emergency Medicine Physician
- Boston, MA
- NPI 1316987993
-
dba Harvard Medical Faculty Physicians
- Multi-Specialty Clinic/Center
- Boston, MA
- NPI 1679397913
-
dba Downstate Health Physicians
- Orthopaedic Surgery Physician
- Brooklyn, NY
- NPI 1386691822
-
dba Downstate Health Physicians
- Child & Adolescent Psychiatry Physician
- Brooklyn, NY
- NPI 1689715476
-
dba Dermatology - HMFP at BIDMC
- Dermatology Physician
- Boston, MA
- NPI 1043250616
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Plymouth, MA
- NPI 1043299001
-
- General Acute Care Hospital
- Boston, MA
- NPI 1548202641
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.