JACKLYNN IBRAHIM
NPI 1063032662
Internal Medicine - Pulmonary Disease in Sherman Oaks, CA
About Jacklynn Ibrahim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKLYNN IBRAHIM (NPI 1063032662) is an individual pulmonary disease provider in Sherman Oaks, California, licensed in California (A207203) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, is affiliated with Nyu Langone Hospitals, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacklynn Ibrahim is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jacklynn Ibrahim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sherman Oaks, CA 91403
- Reassigned Medicare billing, California enrollment
- 26 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Nyu Langone Hospitals
Acute Care Hospitals · New York, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SHERMAN OAKS, CA 91403
SHERMAN OAKS, CA 91403
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacklynn Ibrahim's NPI number?
The NPI number for Jacklynn Ibrahim is 1063032662. It was assigned to this individual provider in the NPPES registry on April 23, 2020.
Where is Jacklynn Ibrahim located?
Jacklynn Ibrahim practices at 4955 Van Nuys Blvd Ste 502, Sherman Oaks, CA 91403. The listed phone number is (818) 325-0200.
What is Jacklynn Ibrahim's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.
Is Jacklynn Ibrahim enrolled in Medicare?
Yes. Jacklynn Ibrahim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jacklynn Ibrahim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacklynn Ibrahim reassigns Medicare benefits to Mid-Valley Pulmonary Medical Group, Inc. (Sherman Oaks, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacklynn Ibrahim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jacklynn Ibrahim affiliated with any hospitals?
According to CMS data, Jacklynn Ibrahim is affiliated with Nyu Langone Hospitals.
When was this NPI record last updated?
The NPPES record for Jacklynn Ibrahim was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jacklynn Ibrahim · NPI 1063032662
Pulmonary Disease physician in Sherman Oaks, California. Individual provider, active in the CMS NPPES registry since April 23, 2020.
## Identity
- **NPI:** 1063032662 (Entity type: Individual)
- **Enumerated:** April 23, 2020
- **Primary specialty:** Internal Medicine - Pulmonary Disease · taxonomy 207RP1001X
- **State license:** A207203 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4955 VAN NUYS BLVD STE 502, Sherman Oaks, CA 91403-1817
- **Phone:** (818) 325-0200
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mid-Valley Pulmonary Medical Group, Inc. (NPI 1689688335, Sherman Oaks, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** June 1, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1063032662) · Data from the CMS NPPES public registry.