Individual provider Active NPI

Joseph Abdellatif Ibrahim, MD

  • Surgical Critical Care Physician
  • Orlando, FL
National Provider Identifier
1902093545
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
ME111076 Issued in FL
Practice address
77 W Underwood St
Ste 200
Orlando, FL 32806-1122
Phone
(407) 649-6884
Fax
(407) 245-7059
NPI assigned
Sep 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 43819 TN
Surgery Physician 208600000X 43819 TN
Surgical Critical Care Physician 2086S0102X ME111076 FL Primary

Addresses

Primary practice location

77 W Underwood St
Ste 200
Orlando, FL 32806-1122

Mailing address

77 W Underwood St
Ste 200
Orlando, FL 32806-1122
Phone (407) 649-6884

Other identifiers 2

IdentifierTypeStateIssuer
004240700MedicaidFL
ME111076OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120104000190 FL Practitioner - General Surgery 7810048642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
East Tennessee State University Quillen College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

77 W Underwood St
Orlando, FL 32806-1122
Phone (407) 896-1100

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue21
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME111076FLMDSurgical Critical Care Physician
43819TNMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jan 1, 2012 Accepting new patients
Orlando Health Medical Group Inc Surgical Critical Care CurrentSince Jan 1, 2012 Accepting new patients

Locations

1920 Don Wickham Dr
Ste 115
Clermont, FL 34711
Phone (352) 323-9530

521 W State Road 434
Ste 110
Longwood, FL 32750

1335 Sligh Blvd
Ste 200
Orlando, FL 32806
Phone (407) 649-6884

77 Underwood St
Ste 200
Orlando, FL 32806
Phone (407) 649-6884

77 Underwood St
Orlando, FL 32806
Phone (407) 649-6884

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jibrahim33292@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1902093545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W UNDERWOOD ST",
            "address_2": "STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061122",
            "telephone_number": "407-649-6884",
            "fax_number": "407-245-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W UNDERWOOD ST",
            "address_2": "STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061122",
            "telephone_number": "407-649-6884",
            "fax_number": "407-245-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "JOSEPH",
        "middle_name": "ABDELLATIF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TN",
            "license": "43819",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "43819",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME111076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004240700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME111076",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.