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ENNIS IBRAHIM DO
NPI 1295676567
Student in an Organized Health Care Education/Training Program in Las Vegas, NV

Active since April 02, 2026PECOS Enrolled
2880 N TENAYA WAY FL 2, LAS VEGAS, NV 89128(702) 769-5937 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ennis Ibrahim Do NPPES

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

ENNIS IBRAHIM DO (NPI 1295676567) is an individual student in an organized health care education/training program in Las Vegas, Nevada and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295676567
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameENNIS IBRAHIMCredential: DO
Location Address2880 N TENAYA WAY FL 2Las Vegas, NV 89128-0618
Mailing Address2880 N Tenaya Way Fl 2Las Vegas, NV 89128-0618 · (702) 769-5937
Phone(702) 769-5937
Sole ProprietorYes
Enumeration DateApril 2, 2026
NPPES CertifiedApril 2, 2026
✔ NPI 1295676567 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.
2880 N TENAYA WAY FL 2, Las Vegas, NV 89128
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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)

Ennis Ibrahim Do 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.

TOMMY CUONG VU MD
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY FL 2
LAS VEGAS, NV 89128
Clark County (702) 427-6398
MUBASHIRA SADIA MD
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY FL 2
LAS VEGAS, NV 89128
Clark County (702) 962-9549
JESMIN RAM
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY FL 2
LAS VEGAS, NV 89128
Clark County (702) 962-9546
DR. WILLIAM DIUGUID DO
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY FL 2
LAS VEGAS, NV 89128
Clark County (702) 769-5937
LIEZEL JASMINE LENHART
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY FL 2
LAS VEGAS, NV 89128
Clark County (702) 962-9546
CHANDELLE RAE NICHOLS DO
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY FL 2
LAS VEGAS, NV 89128
Clark County (702) 480-8916
NICHOLAS JAMES MASON
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY FL 2
LAS VEGAS, NV 89128
Clark County (702) 962-9546
CHONG VUE
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY FL 2
LAS VEGAS, NV 89128
Clark County (702) 427-6398

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 Ennis Ibrahim's NPI number?

The NPI number for Ennis Ibrahim is 1295676567. It was assigned to this individual provider in the NPPES registry on April 2, 2026.

Where is Ennis Ibrahim located?

Ennis Ibrahim practices at 2880 N Tenaya Way Fl 2, Las Vegas, NV 89128. The listed phone number is (702) 769-5937.

What is Ennis 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 Ennis Ibrahim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Ennis Ibrahim was last updated on April 2, 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.