Individual provider Active NPI

Noufal Jajeh

  • Gastroenterology Physician
  • Sidney, OH
National Provider Identifier
1396140604
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
32.125504 Issued in OH
Practice address
930 Wapakoneta Ave
Sidney, OH 45365-1460
Phone
(937) 492-1575
Fax
(937) 949-2707
NPI assigned
Oct 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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 62188 WI
Gastroenterology Physician 207RG0100X 32.125504 OH Primary

Addresses

Primary practice location

930 Wapakoneta Ave
Sidney, OH 45365-1460

Mailing address

930 Wapakoneta Ave
Sidney, OH 45365-1460
Phone (937) 492-1575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150403000523 OH Practitioner - GastroenterologyPractitioner - Internal Medicine 9537487426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

658 W Market St
Suite 117
Lima, OH 45801-4697
Phone (567) 289-9039

Hospital & facility affiliations

  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Mary Rutan Hospital Hospital, Bellefontaine, OH, CCN 360197

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy71
Upper gastrointestinal (GI) endoscopy for acid reflux153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32.125504OHMDGastroenterology Physician
62188WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology and Hepatology of Northwest Ohio Inc Gastroenterology CurrentSince May 1, 2017 Accepting new patients
Mary Rutan Hospital CurrentSince Nov 1, 2020 Accepting new patients
Mary Rutan Hospital Current Accepting new patients
Mary Rutan Hospital CurrentSince Nov 1, 2020 Accepting new patients
Mary Rutan Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2160 Ewing Crawfis Cir
Bellefontaine, OH 43311
Phone (937) 592-9221

205 E Palmer Rd
Bellefontaine, OH 43311
Phone (937) 592-4015

658 W Market St
Ste 117
Lima, OH 45801
Phone (419) 222-3482

930 Wapakoneta Ave
Sidney, OH 45365
Phone (937) 492-1575

209 Lippincott Ln
Urbana, OH 43078
Phone (937) 599-7058

Organizations & group practices 7

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

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": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1396140604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 WAPAKONETA AVE",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453651460",
            "telephone_number": "937-492-1575",
            "fax_number": "937-949-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 WAPAKONETA AVE",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453651460",
            "telephone_number": "937-492-1575",
            "fax_number": "937-949-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAJEH",
        "first_name": "NOUFAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-29",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "62188",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "32.125504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

Verify at the official NPI Registry.