Individual provider Active NPI

Shabana Jawed Jessani, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Chandler, AZ
National Provider Identifier
1437277795
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
32222 Issued in AZ
Practice address
3000 N Arizona Ave
Chandler, AZ 85225-7717
Phone
(480) 827-5540
Fax
(480) 207-2111
NPI assigned
Mar 26, 2007
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 32222 AZ Primary

Addresses

Primary practice location

3000 N Arizona Ave
Chandler, AZ 85225-7717

Mailing address

3000 N Arizona Ave
Chandler, AZ 85225-7717
Phone (480) 827-5540

Other names 1

  • Dr. Shabana Jaffer Ali Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230302002953 AZ Practitioner - Pediatric Medicine 7416320981 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Super Specialists Arizona LLC CurrentSince Feb 1, 2023 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Feb 1, 2023 Accepting new patients
Banner Physician Super Specialists Arizona LLC Current Accepting new patients
Raun D. Melmed Developmental - Behavioral Pediatrics Past Accepting new patients

Locations

3000 N Arizona Ave
Chandler, AZ 85225
Phone (480) 355-1575

1432 S Dobson Rd
Ste 206
Mesa, AZ 85202
Phone (480) 827-5540

1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120

1432 S Dobson Rd
Ste 403
Mesa, AZ 85202
Phone (480) 412-7473

Organizations & group practices 4

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1437277795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N ARIZONA AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257717",
            "telephone_number": "480-827-5540",
            "fax_number": "480-207-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N ARIZONA AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257717",
            "telephone_number": "480-827-5540",
            "fax_number": "480-207-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSANI",
        "first_name": "SHABANA",
        "middle_name": "JAWED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "AZ",
            "license": "32222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHABANA",
            "last_name": "ALI",
            "middle_name": "JAFFER",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.