Individual provider Active NPI

Nasrien Ezzeldin Ibrahim, MD

  • Cardiovascular Disease Physician
  • Boston, MA
National Provider Identifier
1972765543
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
263155 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-5000
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 0101271299 VA
Cardiovascular Disease Physician 207RC0000X 72767 CT
Cardiovascular Disease Physician 207RC0000X 263155 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5000

Other practice location 1

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-2976

Other practice location 2

32 Fruit St
Yawkey 5962
Boston, MA 02114-2620
Phone (617) 643-0712

Other practice location 3

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-7075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, CT, MA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210316001926 DC Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0042536070 Reassigns benefits to 1 organization
I20230103001301 CT Practitioner - Cardiovascular Disease (Cardiology) 0042536070 Reassigns benefits to 1 organization
I20230828002512 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0042536070 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72767CTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Mar 29, 2021 Accepting new patients
Inova Health Care Services Current Accepting new patients
Inova Health Care Services CurrentSince Mar 29, 2021 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Sep 1, 2023 Accepting new patients
Brigham & Womens Hospital, Inc. Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

254 2nd Ave
Needham Heights, MA 02494
Phone (781) 416-8414

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Interoperability endpoints

  • Direct secure messaging: nasrien.ibrahim@xdr.hhchealthdirect.org

Organizations & group practices 6

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1972765543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061028000",
            "country_code": "US",
            "telephone_number": "860-972-2976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "32 Fruit St",
            "address_2": "Yawkey 5962",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142620",
            "country_code": "US",
            "telephone_number": "617-643-0712",
            "fax_number": "617-643-0940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-7075",
            "fax_number": "703-776-2797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "NASRIEN",
        "middle_name": "EZZELDIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "VA",
            "license": "0101271299",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "72767",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "263155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.