Individual provider Active NPI

Mohammad Ibrahim, MD

  • Hospitalist Physician
  • Brooksville, FL
National Provider Identifier
1992725048
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME95660 Issued in FL
Practice address
19101 Cortez Blvd Ste 10065
Brooksville, FL 34601-3013
Phone
(352) 325-9294
Fax
(352) 606-5723
NPI assigned
Jul 20, 2006
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0095660 NJ
Hospitalist Physician 208M00000X ME95660 FL Primary

Addresses

Primary practice location

19101 Cortez Blvd Ste 10065
Brooksville, FL 34601-3013

Mailing address

19101 Cortez Blvd Ste 10065
Brooksville, FL 34601-3013
Phone (352) 573-0240

Other practice location 1

4315 Highland Park Blvd
Ste A
Lakeland, FL 33813-1639
Phone (863) 816-5884

Other practice location 2

17240 Cortez Blvd
Brooksville, FL 34601-8921
Phone (352) 796-5111

Other identifiers 1

IdentifierTypeStateIssuer
275431200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070112000172 FL Practitioner - Internal Medicine 2264432467 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Allied Healthcare LLCGroup PAC ID 1052776366, 29 clinicians
Allied Health Florida IncGroup PAC ID 6507212867, 10 clinicians

Practice addresses (Care Compare)

14690 Spring Hill Dr
Suite 101
Spring Hill, FL 34609-8102
Phone (352) 799-0046

19101 Cortez Blvd
Brooksville, FL 34601-3013
Phone (352) 573-0240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0095660NJMDInternal Medicine Physician
ME95660FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Health Florida Inc. Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Cogent Healthcare of Pensacola LLC Internal Medicine Current Accepting new patients
Cogent Healthcare of Pensacola LLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Allied Healthcare LLC Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Central Florida Inpatient Medicine LLC Internal Medicine CurrentSince Apr 26, 2021 Accepting new patients
Cogent Healthcare of Pensacola LLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Hospitalists of Brandon, LLC. Past Accepting new patients

Locations

119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150

17240 Cortez Blvd
Brooksville, FL 34601
Phone (352) 544-6060

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

1350 13th Ave S
Jax Bch, FL 32250
Phone (904) 247-2900

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

14690 Spring Hill Dr
Ste 101
Spring Hill, FL 34609

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1992725048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19101 CORTEZ BLVD STE 10065",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346013013",
            "telephone_number": "352-573-0240",
            "fax_number": "352-606-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19101 CORTEZ BLVD STE 10065",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346013013",
            "telephone_number": "352-325-9294",
            "fax_number": "352-606-5723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Highland Park Blvd",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338131639",
            "country_code": "US",
            "telephone_number": "863-816-5884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17240 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "346018921",
            "country_code": "US",
            "telephone_number": "352-796-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "ME0095660",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME95660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275431200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.