Mohammad Ibrahim, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

5101027367 Issued in MI

Practice address

1022 N Telegraph Rd Ste 2
Dearborn, MI 48128-1622

Phone

(313) 764-0088

Fax

(313) 254-3586

NPI assigned

May 12, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Sports MedicineAlso: Family Practice, Osteopathic Manipulative Medicine

Education

Michigan State University College of Osteopathic Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mibrahim1041274@direct.trinity-health.org

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.

• Elite Sports & Regenerative Medicine PLLC

  • Sports Medicine (Family Medicine) Physician
  • Dearborn, MI
  • NPI 1619863933
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1962024968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 N TELEGRAPH RD STE 2",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281622",
            "telephone_number": "313-764-0088",
            "fax_number": "313-254-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 N TELEGRAPH RD STE 2",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281622",
            "telephone_number": "313-764-0088",
            "fax_number": "313-254-3586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 N East Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011753",
            "country_code": "US",
            "telephone_number": "517-205-3964",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7575 Grand River Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481149379",
            "country_code": "US",
            "telephone_number": "810-844-7950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 Byron Center Ave SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199606",
            "country_code": "US",
            "telephone_number": "616-252-7389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-12",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101027367",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101027367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ghadir Ibrahim
• Jana Ibrahim
• Joana Ibrahim
• Mahmoud Ibrahim
• Maytham Ibrahim, DMD
• Rama Ibseileh
• Ibtesam M Rafeea M D P C
• Icare Dental
• Icare4Ullc
• Icp LLC

• Sports Medicine (Family Medicine) Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Sports Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.

Verify at the official NPI Registry.