Individual provider Active NPI

Josephine A Pabalan, M.D.

  • Family Medicine Physician
  • Adrian, MI
National Provider Identifier
1336133354
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
JP069482 Issued in MI
Practice address
818 Riverside Ave
Adrian, MI 49221-1446
Phone
(517) 265-0900
Fax
(989) 340-1214
NPI assigned
Sep 6, 2005
Last updated
Oct 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X JP069482 MI Primary

Addresses

Primary practice location

818 Riverside Ave
Adrian, MI 49221-1446

Mailing address

10850 E Traverse Hwy
Suite 4400
Traverse City, MI 49684-1364
Phone (989) 340-1211

Other names 1

  • Dr. Jasmine A Pabalan Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070911000720 MI Practitioner - Family Practice 5698735348 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JP069482MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Covenant Medical Center, Inc Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients

Locations

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1336133354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 E TRAVERSE HWY",
            "address_2": "SUITE 4400",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496841364",
            "telephone_number": "989-340-1211",
            "fax_number": "989-340-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 RIVERSIDE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211446",
            "telephone_number": "517-265-0900",
            "fax_number": "989-340-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABALAN",
        "first_name": "JOSEPHINE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JP069482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMINE",
            "last_name": "PABALAN",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.