Individual provider Active NPI

Gehan Fawzy Ibrahim, M.D.

  • Diagnostic Radiology Physician
  • Columbus, OH
National Provider Identifier
1992090617
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35123970 Issued in OH
Practice address
395 W 12TH Ave
Columbus, OH 43210-1267
Phone
(614) 293-8299
NPI assigned
Jun 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35123970 OH Primary

Addresses

Primary practice location

395 W 12TH Ave
Columbus, OH 43210-1267

Mailing address

395 W 12TH Ave
Columbus, OH 43210-1267
Phone (614) 293-8299

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150709002548 OH Practitioner - Diagnostic Radiology 7012229644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Radiology LLCGroup PAC ID 8921031675, 180 clinicians

Practice addresses (Care Compare)

395 W 12TH Ave
RM 460
Columbus, OH 43210-1267
Phone (614) 293-8315

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Mary Rutan Hospital Hospital, Bellefontaine, OH, CCN 360197
  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35123970OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Radiology LLC Diagnostic Radiology CurrentSince Jun 1, 2015 Accepting new patients

Locations

395 W 12th Ave
Rm 460
Columbus, OH 43210
Phone (614) 293-8299

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

395 W 12th Ave
Columbus, OH 43210
Phone (614) 293-8299

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1992090617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-293-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-293-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "GEHAN",
        "middle_name": "FAWZY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35123970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.