Active NPI
Scott Leonard Jaben, MD
- Ophthalmology Physician
- Charlotte, NC
National Provider Identifier
1174572598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 26271
- Practice address
- 6035 Fairview Rd
Charlotte, NC 28210-3256 - Phone
- (704) 295-3000
- Fax
- (704) 295-3468
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 13244 | SC | |
| Ophthalmology Physician | 207W00000X | 26271 | NC | Primary |
Addresses
Primary practice location
6035 Fairview Rd
Charlotte, NC 28210-3256
Mailing address
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4066591 | Other | NC | AETNA |
| 45506 | Other | NC | BCBS |
| 0841725 | Other | NC | UNITED HEALTHCARE |
| 24174 | Other | NC | KANAWHA |
| 000000292723 | Other | SC | UNISON HEALTH PLAN OF SC |
| 17726 | Other | NC | PARTNERS |
| 771081 | Other | SC | WELLCARE |
| 8945506 | Medicaid | NC | |
| 376563 | Other | NC | MAMSI |
| N26271 | Medicaid | SC | |
| 20002138 | Other | SC | SELECT HEALTH OF SC |
| 26675 | Other | NC | WELLPATH |
| 10725 | Other | NC | BCBS MEDPOINT |
| 10974 | Other | NC | DOCTORS HEALTH PLAN |
| 1641199001 | Other | NC | CIGNA |
| 175003 | Other | NC | COVENTRY |
| 180030820 | Other | RAILROAD MEDICARE | |
| 75511 | Other | NC | MEDCOST |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sjaben5615@direct.ceenta.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091224000047 | NC | Practitioner - Ophthalmology | 1850431768 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13244 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1174572598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JABEN",
"first_name": "SCOTT",
"middle_name": "LEONARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "SC",
"license": "13244",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NC",
"license": "26271",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4066591",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "45506",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0841725",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANAWHA",
"identifier": "24174",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON HEALTH PLAN OF SC",
"identifier": "000000292723",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "17726",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "771081",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8945506",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "376563",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N26271",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH OF SC",
"identifier": "20002138",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "26675",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MEDPOINT",
"identifier": "10725",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOCTORS HEALTH PLAN",
"identifier": "10974",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1641199001",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "175003",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180030820",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "75511",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sjaben5615@direct.ceenta.com",
"affiliation": "N",
"address_1": "6035 Fairview Rd",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282103256",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.