Individual provider Active NPI

Ibrahim Nasser, DC

  • Chiropractor
  • Boynton Beach, FL
National Provider Identifier
1942813985
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13023 Issued in FL
Practice address
1899 N Congress Ave Ste 9
Boynton Beach, FL 33426-8215
Phone
(561) 731-3361
NPI assigned
Aug 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13023 FL Primary

Addresses

Primary practice location

1899 N Congress Ave Ste 9
Boynton Beach, FL 33426-8215

Mailing address

7690 Ardwick Dr
Lake Worth, FL 33467-7716

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210301001522 FL Practitioner - Chiropractic 2769898675 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH13023FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
MDR Advanced Medical Associates Inc Chiropractor CurrentSince Feb 25, 2021 Accepting new patients

Locations

1899 N Congress Ave
Ste 9
Boynton Beach, FL 33426
Phone (561) 573-6667

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1942813985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7690 ARDWICK DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 N CONGRESS AVE STE 9",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268215",
            "telephone_number": "561-731-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSER",
        "first_name": "IBRAHIM",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.