Individual provider Active NPI

Marcus Dominic Jarboe, MD

  • Pediatric Surgery Physician
  • Ann Arbor, MI
National Provider Identifier
1154540466
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
4301090598 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 4301090598 MI
Vascular & Interventional Radiology Physician 2085R0204X 35086254 OH
Surgery Physician 208600000X 4301090598 MI
Surgery Physician 208600000X 35086254 OH
Pediatric Surgery Physician 2086S0120X 35086254 OH
Pediatric Surgery Physician 2086S0120X 4301090598 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

5665 Venture Dr
Dublin, OH 43017-2159
Phone (614) 722-2000

Other practice location 2

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 3

555 S 18th St
Columbus, OH 43205-2654
Phone (614) 722-2000

Other practice location 4

455 Executive Campus Dr
Westerville, OH 43082-8870
Phone (614) 722-2000

Other practice location 5

536 S Trimble Rd
Mansfield, OH 44906-3418
Phone (614) 722-2000

Other identifiers 1

IdentifierTypeStateIssuer
3070322MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090902000242 MI Practitioner - General SurgeryPractitioner - Interventional RadiologyPractitioner - Pediatric MedicinePractitioner - Other (Physician) 5991850612 Reassigns benefits to 4 organizations
I20100723000854 OH Practitioner - Pediatric Medicine 5991850612 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35086254OHMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nationwide Children'S Hospital Pediatrics CurrentSince Sep 24, 2024 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jul 1, 2010 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Children'S Surgical Associates, Corporation Pediatric Surgery CurrentSince Jul 1, 2023 Accepting new patients
Hurley Medical Center CurrentSince Aug 22, 2017 Accepting new patients
Regents of the University of Michigan Surgery CurrentSince Aug 11, 2009 Accepting new patients
Nationwide Children'S Hospital CurrentSince Sep 24, 2024 Accepting new patients
Mercy Health Physicians North Specialty Care LLC Surgery CurrentSince Sep 1, 2021 Accepting new patients
Hurley Medical Center Current Accepting new patients
Promedica Children'S Specialists Pediatrics CurrentSince May 23, 2023 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Feb 7, 2023 Accepting new patients
St Joseph Mercy Hospital Surgery CurrentSince Jul 8, 2022 Accepting new patients
Regents of the University of Michigan Pediatrics Current Accepting new patients
Regents of the University of Michigan CurrentSince Aug 11, 2009 Accepting new patients
Hurley Medical Center Surgery CurrentSince Aug 22, 2017 Accepting new patients
Northwest Pediatric Specialists, LLC Pediatrics CurrentSince Dec 22, 2022 Accepting new patients
SJMH Medical Practice-SMHC Pediatrics CurrentSince Feb 7, 2023 Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients
Mercy Health Physicians-North LLC Pediatrics CurrentSince Jul 1, 2010 Accepting new patients
St Joseph Mercy Hospital CurrentSince Jul 8, 2022 Accepting new patients
Promedica Genito-Urinary Surgeons LLC CurrentSince May 15, 2023 Accepting new patients
Toledo Childrens Hospital Past Accepting new patients
Nationwide Children'S Hospital Toledo, LLC Past Accepting new patients

Locations (25 of 29)

1500 E Medical Center Dr
#D
Ann Arbor, MI 48109
Phone (734) 936-5823

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

Dept 781629
Detroit, MI 48278

1125 S Linden Rd
Ste 100
Flint, MI 48532
Phone (810) 262-6555

1125 S Linden Rd
Ste 500
Flint, MI 48532
Phone (810) 230-2323

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

1200 E Michigan Ave
Ste 460
Lansing, MI 48912
Phone (517) 364-2097

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

555 S 18th St
Columbus, OH 43205
Phone (614) 722-4554

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

5665 Venture Dr
Dublin, OH 43017
Phone (614) 355-8480

536 S Trimble Rd
Mansfield, OH 44906
Phone (419) 528-3150

3521 Briarfield Blvd
Maumee, OH 43537
Phone (419) 794-7259

2120 W Central Ave
Toledo, OH 43606
Phone (419) 531-8558

2222 Cherry St
Ste 1800
Toledo, OH 43608
Phone (419) 251-4300

2121 Hughes Dr
Ste 750
Toledo, OH 43606
Phone (419) 291-7800

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

Interoperability endpoints

  • Direct secure messaging: mjarboe67629@direct.hurleymc.com
  • Direct secure messaging: mjarboe27119@direct.bsmhealth.org
  • FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
  • FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4
  • Direct secure messaging: mjarboe44627@direct.trinity-health.org

Organizations & group practices 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1154540466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5665 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 S 18th St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052654",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "536 S Trimble Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063418",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARBOE",
        "first_name": "MARCUS",
        "middle_name": "DOMINIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4301090598",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OH",
            "license": "35086254",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301090598",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35086254",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OH",
            "license": "35086254",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MI",
            "license": "4301090598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3070322",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.