Nicolas Jabbour, MD
Individual provider Active NPI Surgery Physician · Springfield, MA
NPI 1366485260 · NPPES record last updated Mar 6, 2018
Key facts
- NPI
- 1366485260
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 245727 (MA)
- Practice address
- 759 Chestnut Street
S3677
Springfield, MA 01107-1619 - Phone
- (413) 794-5161
- NPI assigned
- Jun 14, 2006
- Reactivated
- Oct 24, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Owned or controlled facilities with NPI records 9
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Baystate Medical Practices Inc
Practice addresses (Care Compare)
3350 Main St
Springfield, MA 01107-1112
Phone (413) 794-9338
Hospital & facility affiliations
- Baystate Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Baystate Medical Center |
Hospital | Corporate Director | Jan 1, 2024 |
| Baystate Franklin Medical Center |
Hospital | Corporate Director | Jan 1, 2024 |
| Baystate Medical Center |
Hospital | Corporate Director | Jan 1, 2024 |
| Baystate Wing Hospital & Medical Centers |
Hospital | Corporate Director | Jan 1, 2024 |
| Baystate Noble Hospital |
Hospital | Corporate Director | Jan 1, 2024 |
| Baystate Noble Hospital |
Hospital | Corporate Director | Jan 1, 2024 |
| Baystate Home Health |
Home health agency | Corporate Director | Jan 1, 2024 |
| Baystate Hospice |
Hospice | Corporate Director | Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101208001331 | MA | Practitioner - General Surgery |
2567469703 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 245727 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group Inc | Surgery | Current |
Accepting new patients |
| Umass Memorial Medical Group, Inc. | Current |
Accepting new patients | |
| Baystate Medical Practices, Inc | Surgery | Current |
Accepting new patients |
| Zuhdi Transplant Physicians | Past | Accepting new patients | |
| Baystate Franklin Medical Center | Past |
Accepting new patients |
Locations
759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233
280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385
759 Chestnut St
#S3677
Springfield, MA 01107
Phone (413) 794-5161
3350 Main St
Springfield, MA 01107
Phone (413) 784-5437
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 245727 | MA | Yes |
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
Other providers in Springfield, MA
- Adam J Iwanski
- Laure Iyaga
- Smitha S Iyer
- Veeraraghavan J Iyer
- Barry Z Izenstein
- Azad A Jabiev
- Julianne Jablonski
- Rebecca Lynn Jablonski
- Jennifer Jachowski
- Mark A Jackowitz
All providers in Springfield, MA · Surgery Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.