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IHAB IBRAHIM MD
NPI 1417062712
Internal Medicine in San Luis Obispo, CA

Active since August 20, 2006PECOS EnrolledAccepts Medicare Assignment
77 CASA ST, SAN LUIS OBISPO, CA 93405(805) 269-1500(805) 269-1585 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ihab Ibrahim Md NPPES

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

IHAB IBRAHIM MD (NPI 1417062712) is an individual internal medicine provider in San Luis Obispo, California, licensed in California (A49412) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1417062712
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameIHAB IBRAHIMCredential: MD
Location Address77 CASA STSan Luis Obispo, CA 93405-5803
Mailing Address2050 S Blosser RdSanta Maria, CA 93458-7310 · (805) 361-8017 · Fax (805) 361-8097
Phone(805) 269-1500
Fax(805) 269-1585
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateAugust 20, 2006
Last NPPES UpdateJuly 16, 2025
NPPES CertifiedJuly 16, 2025
✔ NPI 1417062712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in CA · A49412✔ Licensed in WA · TD60482949✔ Licensed in HI · MD-7946
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
77 CASA ST, San Luis Obispo, CA 93405
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Other Names 1

Professional Name (2)Ihab Ibrahim Gad Ibrahim Md

Other Identifiers 1

Medicaid1417062712WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan.Insurance ›

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

Ihab Ibrahim 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 ID1456348804
PECOS Enrollment IDI20060502000482
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93405 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
$135.73 typical visit price
range $59.84 – $178.89
Typical copayment $33.93 (range $14.96 – $44.72)
Most-billed visit code 99204
Established Patient
$104.82 typical visit price
range $19.70 – $146.55
Typical copayment $26.20 (range $4.92 – $36.63)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$78.98 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$28.45 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

LAUREN ELVIRA MIRABDOLLAH N.P.
Nurse Practitioner
77 CASA ST, SUITE 201-204
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 269-1500
FIRST CHOICE PHYSICIAN PARTNERS
Internal Medicine
77 CASA ST, SUITE 108
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 541-6225
DR. STEPHEN J TIDIK M.D.
Surgery
77 CASA ST, SUITE 103
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 544-8993
DR. LESLIE G KASANOFF DC
Chiropractor
77 CASA ST, 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 269-1500
MRS. JESSICA M MALONE NP
Nurse Practitioner
77 CASA ST, SUITE 103
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 546-0411
ADAM JOSEPH JANETTE DDS
Dentist (Oral and Maxillofacial Surgery)
77 CASA ST, SUITE 101
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 541-5611
FREDERICK HASEMAN MD
Specialist
77 CASA ST, SUITE 203
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 544-6471
ADAM J. JANETTE, DDS INC.
Dentist (Oral and Maxillofacial Surgery)
77 CASA ST, SUITE 101
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 541-5611

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 Ihab Ibrahim's NPI number?

The NPI number for Ihab Ibrahim is 1417062712. It was assigned to this individual provider in the NPPES registry on August 20, 2006. The provider is also known as Ihab Ibrahim Gad Ibrahim MD.

Where is Ihab Ibrahim located?

Ihab Ibrahim practices at 77 Casa St, San Luis Obispo, CA 93405. The listed phone number is (805) 269-1500.

What is Ihab Ibrahim's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ihab Ibrahim enrolled in Medicare?

Yes. Ihab 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.

What insurance does Ihab Ibrahim accept?

Health plans from PacificSource Health Plans and Providence Health Plan list Ihab Ibrahim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ihab Ibrahim was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.