Individual provider Active NPI

Georges T Jabaly, M.D.

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1407827074
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-07-9322 Issued in OH
Practice address
4405 N Holland Sylvania Rd Ste 104
Toledo, OH 43623-3533
Phone
(419) 882-6784
Fax
(419) 882-4795
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-07-9322 OH Primary

Addresses

Primary practice location

4405 N Holland Sylvania Rd Ste 104
Toledo, OH 43623-3533

Mailing address

4405 N Holland Sylvania Rd Ste 104
Toledo, OH 43623-3533
Phone (419) 882-6784

Other identifiers 1

IdentifierTypeStateIssuer
2271689MedicaidOH

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
I20040616000389 OH Practitioner - Family PracticePractitioner - Emergency Medicine 5092799320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4405 N Holland Sylvania Rd
Suite 104
Toledo, OH 43623-3533
Phone (419) 882-6784

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
GJ International Consultants, Inc Family Medicine CurrentSince Apr 2, 2004 Accepting new patients
Medical Emergency Treatment Corporation Past Accepting new patients
Hospitalist Medicine Physicians of Sylvania LTD Past Accepting new patients
House Calls Physicians PLLC Family Medicine PastSince May 19, 2011 Accepting new patients
Riverwood Emergency Services Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4405 N Holland Sylvania Rd
Ste 104
Toledo, OH 43623
Phone (419) 882-6784

Interoperability endpoints

  • Direct secure messaging: gjabaly80187@direct.bsmhealth.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 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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1407827074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 N HOLLAND SYLVANIA RD STE 104",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233533",
            "telephone_number": "419-882-6784",
            "fax_number": "419-882-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 N HOLLAND SYLVANIA RD STE 104",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233533",
            "telephone_number": "419-882-6784",
            "fax_number": "419-882-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABALY",
        "first_name": "GEORGES",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-07-9322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2271689",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.