Individual provider Active NPI

Lisa K. Jablon, M.D.

  • Surgical Critical Care Physician
  • Philadelphia, PA
National Provider Identifier
1023110152
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
MD037734E Issued in PA
Practice address
9880 Bustleton Ave
Suite 205
Philadelphia, PA 19115-2185
Phone
(215) 676-2222
Fax
(215) 676-5923
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X MD037734E PA Primary

Addresses

Primary practice location

9880 Bustleton Ave
Suite 205
Philadelphia, PA 19115-2185

Mailing address

101 E Olney Ave
Suite 505
Philadelphia, PA 19120-2421
Phone (215) 456-7000

Other identifiers 1

IdentifierTypeStateIssuer
1255425MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110526000288 PA Practitioner - General Surgery 1153508247 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD037734EPAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Jun 26, 1990 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc CurrentSince Jun 26, 1990 Accepting new patients

Locations

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5401 Old York Rd
Ste 501
Philadelphia, PA 19141
Phone (215) 456-6127

9880 Bustleton Ave
Ste 205
Philadelphia, PA 19115
Phone (215) 676-2222

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

Interoperability endpoints

  • Direct secure messaging: lisa.jablon@direct.einstein.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023110152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "SUITE 505",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202421",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9880 BUSTLETON AVE",
            "address_2": "SUITE 205",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152185",
            "telephone_number": "215-676-2222",
            "fax_number": "215-676-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABLON",
        "first_name": "LISA",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD037734E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255425",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.