Thiago Antonio Jabuonski, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

MD61169747 Issued in WA

Practice address

12728 19TH Ave SE Ste 200
Everett, WA 98208-6526

Phone

(425) 252-1116

Fax

(425) 252-1118

NPI assigned

Mar 6, 2012

Last updated

Feb 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Critical Care (Intensivists)Also: Pulmonary Disease

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Washington Medical Group Inc PSGroup PAC ID 7517870314, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014
• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjabuonski45652@skagit.direct-ci.com
• Direct secure messaging: tjabuonski727172@direct.multicare.org

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.

• Western Washington Medical Group, Inc PS

  dba WWMG Department of Psychiatry

  • Psychiatry Physician
  • Everett, WA
  • NPI 1396413803
  Medicare reassignment Care Compare group NPD
• Public Hospital Dist No 1 Skagit

  dba Skagit Regional Clinics

  • General Practice Physician
  • Mount Vernon, WA
  • NPI 1023332749
  Medicare reassignment NPD
• Public Hospital Dist No 1 Skagit

  dba Skagit Regional Health - Mount Vernon Physical Therapy

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1811460652
  NPD
• Public Hospital District No 1 Skagit

  dba Skagit Regional Health - Arlington Pediatrics

  • Pediatrics Physician
  • Arlington, WA
  • NPI 1043241540
  NPD
• Western Washington Medical Group, Inc PS

  dba Western Wa Med Grp Dept of Pulmonary, Sleep Disorders, Critical Care

  • Pulmonary Disease Physician
  • Everett, WA
  • NPI 1215155619

  Critical Care Medicine

  NPD
• Western Washington Medical Group, Inc PS

  dba Western Washington Medical Group Dept of Infectious Disease

  • Infectious Disease Physician
  • Everett, WA
  • NPI 1427816305
  NPD
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  NPD (past)
• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  NPD (past)

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

• Providence Health & Services-Wa

  dba Providence Regional Medical Center Everett

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation
• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1053685107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE STE 200",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-252-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE STE 200",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-252-1116",
            "fax_number": "425-252-1118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744126",
            "country_code": "US",
            "telephone_number": "360-424-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JABUONSKI",
        "first_name": "THIAGO",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-06",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD61169747",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "BC61190205",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "BC61190205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjabuonski45652@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1415 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yutaka Iwamoto
• Lica Iwasaki
• Yukako Izawa, LMP
• Francis Jabido
• Conrad Jablonski, MD
• Marina P Jackin, MS, LMHCA
• Amanda Price Jackson, M.D.
• Christine Jackson
• Dana McBride Jackson, ARNP
• Diane L Jackson

• Critical Care Medicine (Internal Medicine) Physician in Everett, WA
• Providers in Everett, WA by specialty
• Critical Care Medicine (Internal Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.