Sallu M. Jabati, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36200 Issued in AZ

Practice address

3130 N Arizona Ave Ste 112
Chandler, AZ 85225-7163

Phone

(480) 292-8579

Fax

(480) 306-6029

NPI assigned

Feb 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• M&M Interventional Spine and Joint PLLC

  • Pain Clinic/Center
  • Chandler, AZ
  • NPI 1417280918
  NPD (past) Authorized official
• Toledo Pain Services, PLL

  • Interventional Pain Medicine Physician
  • Toledo, OH
  • NPI 1356339857
  NPD (past)
• Toledo Pain Services, PLL

  • Certified Registered Nurse Anesthetist
  • Oregon, OH
  • NPI 1427703024
  NPD (past)

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1235104431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 SHADOW LOCH DR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247455",
            "telephone_number": "678-559-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N ARIZONA AVE STE 112",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257163",
            "telephone_number": "480-292-8579",
            "fax_number": "480-306-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABATI",
        "first_name": "SALLU",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AZ",
            "license": "36200",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "36200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299505",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Elise Ivy
• Isabella Izdebski
• J Keith Braun MD PC
• J. Grant Johansen DMD PLLC
• J&Bhealthcare LLC
• Khaldoun Jabi, MD
• Rebecca Jacewicz
• Jack Wright Dentistry PC
• Brianna Lynn Jack, M.A,BCBA,LBA
• Jackson Taravine Sr

• Internal Medicine Physician in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.

Verify at the official NPI Registry.