Individual provider Active NPI

Anthony Jabra, DPM

  • Foot & Ankle Surgery Podiatrist
  • New York, NY
National Provider Identifier
1104275940
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N007000 Issued in NY
Practice address
53 E 124TH St
New York, NY 10035-1815
Phone
(212) 410-8100
NPI assigned
Jun 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N007000 NY Primary

Addresses

Primary practice location

53 E 124TH St
New York, NY 10035-1815

Mailing address

53 E 124TH St
New York, NY 10035-1815
Phone (212) 410-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624001473 NY Practitioner - Podiatry 5597099671 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1840

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue33
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N007000NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Aug 22, 2024 Accepting new patients
Foot Clinics of New York CurrentSince Jul 1, 2019 Accepting new patients
Metropolitan Medical Practice Plan PC CurrentSince Jul 1, 2019 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Jul 30, 2023 Accepting new patients
Upper Room AIDS Ministry, Inc. Adult Day Health Care Center. CurrentSince Oct 21, 2019 Accepting new patients
Harlem Medical Associates PC CurrentSince Jul 1, 2019 Accepting new patients
Shlomit Levy PastSince Oct 21, 2019 Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

53 E 124th St
New York, NY 10035
Phone (212) 410-8000

169 W 133rd St
New York, NY 10030
Phone (646) 762-4950

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

306 Malcolm X Blvd
Fl 3
New York, NY 10027
Phone (212) 803-2850

55 E 124th St
New York, NY 10035
Phone (212) 410-8112

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: anthony.jabra@uram.eclinicaldirectplus.com
  • Direct secure messaging: ajabra873686@nychhc.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1104275940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 E 124TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351815",
            "telephone_number": "212-410-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 E 124TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351815",
            "telephone_number": "212-410-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABRA",
        "first_name": "ANTHONY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N007000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.