NPIMap

Individual provider Active NPI

Andres Jose Jadue Tobar, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charleston, WV
National Provider Identifier
1265911234
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
57.246254 Issued in OH
Practice address
280 Silver Maple RDG
Charleston, WV 25306-1122
Phone
(216) 466-4250
NPI assigned
Aug 10, 2018
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 57.246254 OH Primary

Addresses

Primary practice location

280 Silver Maple RDG
Charleston, WV 25306-1122

Mailing address

280 Silver Maple RDG
Charleston, WV 25306-1122
Phone (216) 466-4250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220322002116 WV Practitioner - Thoracic Surgery 0244625655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3100 Maccorkle Ave SE
Suite 101
Charleston, WV 25304-1215
Phone (304) 388-5590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.246254OHMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. Single Specialty CurrentSince Feb 23, 2022 Accepting new patients
Charleston Area Medical Center Inc Single Specialty CurrentSince Feb 23, 2022 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Charleston Area Medical Center, Inc. Single Specialty Past Accepting new patients

Locations

3100 Maccorkle Ave SE
Ste 101
Charleston, WV 25304
Phone (304) 388-5395

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1265911234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SILVER MAPLE RDG",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253061122",
            "telephone_number": "216-466-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SILVER MAPLE RDG",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253061122",
            "telephone_number": "216-466-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADUE TOBAR",
        "first_name": "ANDRES",
        "middle_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-10",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "57.246254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.