Individual provider Active NPI

Hala Al Jiboury

  • Gastroenterology Physician
  • Tampa, FL
National Provider Identifier
1356626402
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME155625 Issued in FL
Practice address
3000 Medical Park Dr Ste 500
Tampa, FL 33613-6600
Phone
(813) 615-7028
Fax
(813) 615-8008
NPI assigned
Oct 19, 2011
Last updated
Dec 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A123602 CA
Gastroenterology Physician 207RG0100X ME155625 FL Primary

Addresses

Primary practice location

3000 Medical Park Dr Ste 500
Tampa, FL 33613-6600

Mailing address

509 SE Riverside Dr Ste 303
Stuart, FL 34994-2579
Phone (772) 283-9111

Other practice location 1

509 SE Riverside Dr Ste 303
Stuart, FL 34994-2579
Phone (772) 283-9111

Other names 1

  • Hala Al-Jiboury Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131226000148 CA Practitioner - Internal MedicinePractitioner - Family Practice 7214164045 Reassigns benefits to 1 organization
I20221011000650 FL Practitioner - Gastroenterology 7214164045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Toledo College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

3000 Medical Park Dr
Suite 320
Tampa, FL 33613-4681
Phone (813) 910-0027

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 615-7075

8702 Hunters Lake Dr
Suite 100
Tampa, FL 33647-2855
Phone (813) 467-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
49.11 of 100Reported as group
Quality
6.22
Promoting interoperability
99
Improvement activities
0
Cost
74.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy41
Upper gastrointestinal (GI) endoscopy for acid reflux41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A123602CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Gastroenterology CurrentSince Jan 15, 2024 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

3000 Medical Park Dr
Ste 500
Tampa, FL 33613
Phone (813) 615-7028

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: haljiboury1650489@adventhealth.direct-ci.com
  • Direct secure messaging: haljiboury2500993@direct.ccf.org

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.

Hospital & facility affiliations 3

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": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1356626402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 SE RIVERSIDE DR STE 303",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942579",
            "telephone_number": "772-283-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336136600",
            "telephone_number": "813-615-7028",
            "fax_number": "813-615-8008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 SE Riverside Dr Ste 303",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349942579",
            "country_code": "US",
            "telephone_number": "772-283-9111",
            "fax_number": "772-283-2955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL JIBOURY",
        "first_name": "HALA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A123602",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME155625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALA",
            "last_name": "AL-JIBOURY",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.