Albert Kenneth Jabbour, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

516 Issued in WV

Practice address

9500 Bonita Beach Rd SE Ste 100
Bonita Springs, FL 34135-4698

Phone

(239) 498-9294

Fax

(239) 798-7179

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Johnson Health CenterGroup PAC ID 9537060413, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JCFEAA/Endpoint/JCFEAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment NPD
• Johnson Health Center

  • Federally Qualified Health Center (FQHC)
  • Madison Heights, VA
  • NPI 1972858660
  Care Compare group NPD
• Pulsemd Bonita LLC

  • Urgent Care Clinic/Center
  • Bonita Springs, FL
  • NPI 1548960842
  Medicare reassignment
• Johnson Health Center

  • Federally Qualified Health Center (FQHC)
  • Lynchburg, VA
  • NPI 1316926538
  Medicare reassignment
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD
• Johnson Health Center

  • Pharmacy
  • Lynchburg, VA
  • NPI 1962709287
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1013131119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-798-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 BONITA BEACH RD SE STE 100",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354698",
            "telephone_number": "239-498-9294",
            "fax_number": "239-798-7179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30410 Highway 200",
            "address_purpose": "LOCATION",
            "city": "Ponderay",
            "state": "ID",
            "postal_code": "838529601",
            "country_code": "US",
            "telephone_number": "208-263-7101",
            "fax_number": "208-263-7198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JABBOUR",
        "first_name": "ALBERT",
        "middle_name": "KENNETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117096",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Theresa Ippolito
• Luckner Isme I
• IV Drug Solutions
• J-M Ward Enterprises LLC
• J&JL Enterprises, LLC D/B/a J&J Louis Enterprises, LLC (John'S Pharmac
• Scott H Jaffe, M.D
• Gabriela Jamur
• Javier Alfonso de la Cruz, PLLC
• JCR DMD LC
• Je Med Supplies and Services LC

• Medical Physician Assistant in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.