NPIMap

Individual provider Active NPI

Jabulani Munalula, MD

  • Surgical Oncology Physician
  • Portsmouth, VA
National Provider Identifier
1437105467
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
0101241103 Issued in VA
Practice address
355 Crawford St
Suite 300
Portsmouth, VA 23704-2816
Phone
(757) 396-6333
Fax
(757) 396-6367
NPI assigned
May 25, 2006
Last updated
Dec 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101241103 VA
Surgical Oncology Physician 2086X0206X 0101241103 VA Primary

Addresses

Primary practice location

355 Crawford St
Suite 300
Portsmouth, VA 23704-2816

Mailing address

355 Crawford St
Suite 102
Portsmouth, VA 23704-2816
Phone (757) 397-3400

Other identifiers 7

IdentifierTypeStateIssuer
0162448OtherGHI
301730OtherVAANTHEM BCBS
755184OtherAETNA
P00638801OtherMEDICARE RAILROAD
5908181MedicaidNC
10022031OtherOPTIMA
1437105467MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101241103VAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Oncology Associates PC Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1437105467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 CRAWFORD ST",
            "address_2": "SUITE 102",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042816",
            "telephone_number": "757-397-3400",
            "fax_number": "757-399-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 CRAWFORD ST",
            "address_2": "SUITE 300",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042816",
            "telephone_number": "757-396-6333",
            "fax_number": "757-396-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNALULA",
        "first_name": "JABULANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101241103",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "VA",
            "license": "0101241103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0162448",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "301730",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "755184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00638801",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908181",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "10022031",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437105467",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.