Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Ibrahim

Individual provider Physical Therapist · NPI 1194619353

Mary Ibrahim is a Physical Therapist in Private Practice in Bayonne, New Jersey. Qualified in 2024, 2 years ago. Practices with Sportscare of America, PC, a 132-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
2
Licensed in
NJ
In the registry since
2025
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Practice location Address checks out

151 Centre St Ste A
Bayonne, NJ 07002-7224
Phone: (201) 858-0550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA02334900 (NJ)

Record details

NPI number1194619353
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 4, 2025
Last updated in NPPESJune 4, 2025
Certification dateJune 4, 2025
Mailing address151 Centre St Ste A, Bayonne, NJ 07002-7224

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Sportscare Of America, Pc — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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