Ebteehal Adnan Ismail

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

126735 Issued in IA

Practice address

588 Longmeadow St
Longmeadow, MA 01106-2292

Phone

(413) 565-1000

NPI assigned

Jul 5, 2022

Last updated

Sep 10, 2024By the provider in NPPES

Sex

Female

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 IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Iowa Emergency Services LLC

  • Emergency Medicine Physician
  • Clinton, IA
  • NPI 1821591454
  Medicare reassignment
• Vituity-Iowa PLLC

  • Emergency Medicine Physician
  • Davenport, IA
  • NPI 1437932928
  Medicare reassignment
• Vituity-Iowa PLLC

  • Emergency Medicine Physician
  • Bettendorf, IA
  • NPI 1871378752
  NPD

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1962135269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 LONGMEADOW ST",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011062292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 LONGMEADOW ST",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011062292",
            "telephone_number": "413-565-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "EBTEEHAL",
        "middle_name": "ADNAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "126735",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norsha Brittany Hydol
• Gabrielle Hyrkas
• Osarume Idahor
• Judith Ingraham, PT
• Jody Riemi Ishibashi
• Alexandria Jacobs
• Jag Geriatrics PC
• Udaya B Jagadeesan, M.D.
• James E Dores DMD, PC
• James M Freeman, M.D.

• Physician Assistant in Longmeadow, MA
• Providers in Longmeadow, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.