NPIMap

Individual provider Active NPI

Wissam A Jaber, M.D.

  • Interventional Cardiology Physician
  • Atlanta, GA
National Provider Identifier
1053390427
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
66954 Issued in GA
Practice address
550 Peachtree St NE
Mot 6TH Floor Cardiology
Atlanta, GA 30308-2208
Phone
(404) 686-1474
Fax
(404) 686-4445
NPI assigned
Jan 12, 2006
Last updated
Aug 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 66954 GA
Interventional Cardiology Physician 207RI0011X 66954 GA Primary

Addresses

Primary practice location

550 Peachtree St NE
Mot 6TH Floor Cardiology
Atlanta, GA 30308-2208

Mailing address

550 Peachtree St NE
Mot 6TH Floor Cardiology
Atlanta, GA 30308-2208
Phone (404) 686-1474

Other identifiers 2

IdentifierTypeStateIssuer
421417307P4OtherIAUHC/RIVER VALLEY/JD PREMIER
1053390427MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111026000800 GA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2163405309 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66954GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Nov 1, 2011 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Nov 1, 2011 Accepting new patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince May 14, 2018 Accepting new patients
The Emory Clinic Inc Cardiovascular Disease CurrentSince Nov 1, 2011 Accepting new patients
Emory Health Care Past Accepting new patients
Crawford Long Hospital Past Accepting new patients
The Emory Clinic Pediatric Providers Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

550 Peachtree St NE
Fl 6
Atlanta, GA 30308
Phone (404) 686-2513

80 Butler St SE
Atlanta, GA 30368
Phone (404) 327-5920

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

Interoperability endpoints

  • Direct secure messaging: wjaber42554@direct.emory.org

Organizations & group practices 7

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1053390427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "address_2": "MOT 6TH FLOOR CARDIOLOGY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082208",
            "telephone_number": "404-686-1474",
            "fax_number": "404-686-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "address_2": "MOT 6TH FLOOR CARDIOLOGY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082208",
            "telephone_number": "404-686-1474",
            "fax_number": "404-686-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABER",
        "first_name": "WISSAM",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "66954",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "66954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC/RIVER VALLEY/JD PREMIER",
            "identifier": "421417307P4",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053390427",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.