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DR. IHSAN I JABBOUR M.D. NPI 1407899610


NPI Information

NPI: 1407899610
Provider Name: DR. IHSAN I JABBOUR, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 07D0931044

Address:
171 GRANDVIEW AVE
SUITE # 105
WATERBURY, CT
ZIP 06708
Phone: (203) 755-2214
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DR. Ihsan I Jabbour, M.D. is a general practice in Waterbury, CT with 48 years of experience. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Ihsan I Jabbour, M.D. NPI is 1407899610. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

171 GRANDVIEW AVE
SUITE # 105
WATERBURY, CT
ZIP 06708-517
Phone: (203) 755-2214
Fax: (203) 596-1133

The NPI 1407899610 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 07D0931044 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • Removal of skin and tissue (HCPCS:11045)
  • Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)
  • Administration of influenza virus vaccine (HCPCS:G0008)

The enumeration date for this NPI number is 6/14/2006 and was last updated on 1/19/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207PE0005XEmergency MedicineUndersea and Hyperbaric Medicine026820CONNECTICUTNo
2207Q00000XFamily Medicine026820CONNECTICUTNo
3208600000XSurgery026820CONNECTICUTNo
4208D00000XGeneral Practice026820CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10004112221OTHERCONNECTICUTAETNA
2P2041646OTHERCONNECTICUTOXFORD
3061212173 0005OTHERTENNESSEECIGNA
4712173OTHERCONNECTICUTCONNECTICARE
5020000553MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUT
6001268200MEDICAIDCONNECTICUT
7010026820CT03OTHERCONNECTICUTBC/BS
8B83692MEDICARE UPINCONNECTICUT
9026820CT NO2OTHERCONNECTICUTCONNECTICARE
10061212173OTHERCONNECTICUTAEBH
11135799OTHERFLORIDAWELLCARE
12061212173OTHERUTAHUNITED HEALTH CARE
130R0697OTHERCONNECTICUTPHS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.