Individual provider Active NPI

Serge A. Jabbour, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Philadelphia, PA
National Provider Identifier
1235152315
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD063190L Issued in PA
Practice address
211 S 9TH St
Suite 600
Philadelphia, PA 19107-6810
Phone
(215) 955-1925
Fax
(215) 928-3160
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD063190L PA Primary

Addresses

Primary practice location

211 S 9TH St
Suite 600
Philadelphia, PA 19107-6810

Mailing address

211 S 9TH St
Suite 600
Philadelphia, PA 19107-6810
Phone (215) 955-1925

Other identifiers 2

IdentifierTypeStateIssuer
001741427MedicaidPA
7916302MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20050207000809 PA Practitioner - Endocrinology 5395796346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1101 Market St
FL 19
Philadelphia, PA 19107-2926

111 S 11TH St
Philadelphia, PA 19107-4824

211 S 9TH St
Philadelphia, PA 19107-6810

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-7444

834 Walnut St
Suite 110
Philadelphia, PA 19107-5109
Phone (215) 503-4779

925 Chestnut St
Philadelphia, PA 19107-4204

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jul 1, 1999 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

443 Laurel Oak Rd
Ste 230
Voorhees, NJ 08043
Phone (609) 741-0122

111 S 11th St
Ste 4240
Philadelphia, PA 19107
Phone (215) 955-6550

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

211 S 9th St
Ste 600
Philadelphia, PA 19107
Phone (215) 955-1925

Organizations & group practices 2

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 6

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1235152315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S 9TH ST",
            "address_2": "SUITE 600",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076810",
            "telephone_number": "215-955-1925",
            "fax_number": "215-928-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 9TH ST",
            "address_2": "SUITE 600",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076810",
            "telephone_number": "215-955-1925",
            "fax_number": "215-928-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABBOUR",
        "first_name": "SERGE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD063190L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001741427",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7916302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.