NPIMap

Individual provider Active NPI

Nicolas Jabbour, MD

  • Surgery Physician
  • Springfield, MA
National Provider Identifier
1366485260
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
245727 Issued in MA
Practice address
759 Chestnut Street
S3677
Springfield, MA 01107-1619
Phone
(413) 794-5161
NPI assigned
Jun 14, 2006
Reactivated
Oct 24, 2007
Last updated
Mar 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 245727 MA Primary

Addresses

Primary practice location

759 Chestnut Street
S3677
Springfield, MA 01107-1619

Mailing address

280 Chestnut St
2ND Floor
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20101208001331 MA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 2567469703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

3350 Main St
Springfield, MA 01107-1112
Phone (413) 794-9338

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245727MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc Surgery CurrentSince Jul 15, 2016 Accepting new patients
Umass Memorial Medical Group Inc Surgery CurrentSince Aug 13, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Aug 13, 2023 Accepting new patients
Baystate Franklin Medical Center PastSince Jan 1, 2024 Accepting new patients
Zuhdi Transplant Physicians Past Accepting new patients

Locations

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

3350 Main St
Springfield, MA 01107
Phone (413) 784-5437

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

759 Chestnut St
#S3677
Springfield, MA 01107
Phone (413) 794-5161

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Ownership & related parties

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baystate Medical CenterSpringfield, MA, CCN 220077 Hospital Corporate Director Jan 1, 2024
Baystate Franklin Medical CenterGreenfield, MA, CCN 220016 Hospital Corporate Director Jan 1, 2024
Baystate Medical CenterSpringfield, MA, CCN 22S077 Hospital Corporate Director Jan 1, 2024
Baystate Wing Hospital & Medical CentersPalmer, MA, CCN 220030 Hospital Corporate Director Jan 1, 2024
Baystate Noble HospitalWestfield, MA, CCN 220065 Hospital Corporate Director Jan 1, 2024
Baystate Noble HospitalWestfield, MA, CCN 22T065 Hospital Corporate Director Jan 1, 2024
Baystate Home HealthWest Springfield, MA, CCN 227011 Home health agency Corporate Director Jan 1, 2024
Baystate HospiceWest Springfield, MA, CCN 221521A Hospice Corporate Director Jan 1, 2024

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1366485260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 CHESTNUT STREET",
            "address_2": "S3677",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071619",
            "telephone_number": "413-794-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABBOUR",
        "first_name": "NICOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2018-03-06",
        "deactivation_date": "2007-08-01",
        "reactivation_date": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "245727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.