Individual provider Active NPI

Wissam S Jaber, MD

  • Pulmonary Disease Physician
  • Atlanta, GA
National Provider Identifier
1396922878
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
81259 Issued in GA
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-3007
Phone
(404) 712-2000
NPI assigned
Jan 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD.31651 AL
Internal Medicine Physician 207R00000X 1447 GA
Pulmonary Disease Physician 207RP1001X 51115 AZ
Pulmonary Disease Physician 207RP1001X 81259 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-3007

Mailing address

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone (623) 207-3919

Other practice location 1

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone (623) 207-3919

Other practice location 2

902 N 7th St # 100
Cordele, GA 31015-3234
Phone (229) 276-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, GA2 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
I20170301001649 AZ Practitioner - Pulmonary Disease 5496901225 Reassigns benefits to 1 organization
I20190116001250 GA Practitioner - Pulmonary Disease 5496901225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1447GAMDOptometrist
MD.31651ALMDSpecialist
81259GAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Dec 1, 2018 Accepting new patients
Emory Medical Care Foundation Inc Internal Medicine CurrentSince Dec 1, 2018 Accepting new patients
The Emory Clinic Inc Internal Medicine CurrentSince Dec 1, 2018 Accepting new patients
City of Hope Medical Group of Arizona LLC Internal Medicine CurrentSince Feb 1, 2017 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Emory Health Care Past Accepting new patients

Locations

14200 W Celebrate Life Way
Goodyear, AZ 85338
Phone (623) 207-3000

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Butler St SE
Atlanta, GA 30368
Phone (404) 327-5920

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

6325 Hospital Pkwy
Johns Creek, GA 30097
Phone (404) 251-1880

6897 Paysphere Cir
Chicago, IL 60674
Phone (480) 586-7542

Interoperability endpoints

  • Direct secure messaging: wjaber42562@direct.emory.org

Organizations & group practices 6

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 6

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": "1201392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1396922878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14200 W CELEBRATE LIFE WAY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383007",
            "telephone_number": "623-207-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303223007",
            "telephone_number": "404-712-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14200 W Celebrate Life Way",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853383007",
            "country_code": "US",
            "telephone_number": "623-207-3919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 N 7th St # 100",
            "address_purpose": "LOCATION",
            "city": "Cordele",
            "state": "GA",
            "postal_code": "310153234",
            "country_code": "US",
            "telephone_number": "229-276-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JABER",
        "first_name": "WISSAM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-27",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "MD.31651",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "1447",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "51115",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "81259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.