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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

IMIKOMOBONG EKOPIMO IBIA MD
NPI 1285122762
Emergency Medicine in Boston, MA

Active since April 30, 2018PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 10, 2026, Jun 4, 2026, Sep 10, 2025 and 4 more (7 updates tracked since 2018).

About Imikomobong Ekopimo Ibia Md NPPES

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

IMIKOMOBONG EKOPIMO IBIA MD (NPI 1285122762) is an individual emergency medicine provider in Boston, Massachusetts, licensed in Georgia (109444) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, is affiliated with Reston Hospital Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1285122762
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameIMIKOMOBONG EKOPIMO IBIACredential: MD
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address55 Fruit StBoston, MA 02114-2621 · (617) 724-4100
Phone(617) 724-4100
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateApril 30, 2018
Last NPPES UpdateAugust 10, 20267 updates tracked since enumeration
NPPES CertifiedAugust 10, 2026
✔ NPI 1285122762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in GA · 109444✔ Licensed in MA · 290390
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedPediatrics · Pediatric Emergency MedicineTaxonomy 2080P0204X · License 290390 (MA)
55 FRUIT ST, Boston, MA 02114
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Secondary Practice Locations 3

Location 11133 EAGLES LANDING PKWYSTOCKBRIDGE, GA 30281-5085 · Phone (678) 604-1000 · Fax (770) 389-2133
Location 275 Francis StBoston, MA 02115-6110 · Phone (617) 732-5636
Location 3300 Longwood AveBoston, MA 02115-5724 · Phone (617) 355-6000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Imikomobong Ekopimo Ibia Md 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.

PECOS PAC ID9133478670
PECOS Enrollment IDI20240806003390, I20251001000001
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
104 services104 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
47 services45 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
21 services20 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Reston Hospital Center

Acute Care Hospitals · Reston, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490107
Location1850 Town Center ParkwayReston, VA 20190 · Fairfax County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Imikomobong Ibia's NPI number?

The NPI number for Imikomobong Ibia is 1285122762. It was assigned to this individual provider in the NPPES registry on April 30, 2018.

Where is Imikomobong Ibia located?

Imikomobong Ibia practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 724-4100.

What is Imikomobong Ibia's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Imikomobong Ibia enrolled in Medicare?

Yes. Imikomobong Ibia 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.

Is Imikomobong Ibia affiliated with any hospitals?

According to CMS data, Imikomobong Ibia is affiliated with Reston Hospital Center.

When was this NPI record last updated?

The NPPES record for Imikomobong Ibia was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.