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MARYAM KHALIL IBRAHIM MD
NPI 1154943157
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since May 12, 2020PECOS Enrolled

NPPES record last updated: February 18, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 18, 2022, May 12, 2020 (2 updates tracked since 2020).

About Maryam Khalil Ibrahim Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYAM KHALIL IBRAHIM MD (NPI 1154943157) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154943157
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMARYAM KHALIL IBRAHIMCredential: MD
Location Address55 FRUIT STBoston, MA 02114
Mailing Address1 Emerson Place, Apt 4pBoston, MA 02114 · (617) 697-5705
Phone(617) 724-4133
Sole ProprietorYes
Enumeration DateMay 12, 2020
Last NPPES UpdateFebruary 18, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 18, 2022
✔ NPI 1154943157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
55 FRUIT ST, Boston, MA 02114
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maryam Khalil Ibrahim Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

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 Maryam Ibrahim's NPI number?

The NPI number for Maryam Ibrahim is 1154943157. It was assigned to this individual provider in the NPPES registry on May 12, 2020.

Where is Maryam Ibrahim located?

Maryam Ibrahim practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 724-4133.

What is Maryam Ibrahim's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Maryam Ibrahim enrolled in Medicare?

Yes. Maryam Ibrahim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maryam Ibrahim was last updated on February 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.