Individual provider Active NPI

Maxwell John Jabaay, DO

  • Surgery Physician
  • Rochester, MN
National Provider Identifier
1023755923
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
74753 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
May 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 32554 MN
Surgery Physician 208600000X 74753 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjabaay1739093@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20230815002527 MN Practitioner - General Surgery 9133509953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Alabama College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

1216 2ND St SW
Rochester, MN 55902-1906
Phone (507) 255-5123

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32554MNMDEmergency Medical Services (Emergency Medicine) Physician
74753MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince Jul 11, 2023 Accepting new patients
Mayo Clinic CurrentSince Jul 11, 2023 Accepting new patients
Mayo Clinic Current Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: mjabaay1739093@ehrdirect.mayoclinicmsg.org

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": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1023755923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABAAY",
        "first_name": "MAXWELL",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-13",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "32554",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "74753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjabaay1739093@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.