Juan C Ibla, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

204925 Issued in MA

Practice address

300 Longwood Ave
Boston, MA 02115-5724

Phone

(617) 355-7737

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jibla22011@direct.bostonchildrens.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.

• CHMC Anesthesia Foundation Inc

  • Pediatric Anesthesiology Physician
  • Boston, MA
  • NPI 1831268754
  Medicare reassignment NPD

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1962471284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBLA",
        "first_name": "JUAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "204925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia N Ibeabuchi, R.N.
• Ibeam Medical Massachusetts
• Nathanaelle Onyinyechi Ibeziako
• Patricia I Ibeziako, MD
• Imikomobong Ekopimo Ibia, MD
• Mam Ismaail Ibraheem, MD, MPH
• Amir E Ibrahim, MD
• Fadi Ibrahim, MD
• Ishaq O Ibrahim, MD
• Khaled Ibrahim

• Anesthesiology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Anesthesiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.