Individual provider Active NPI

Jeanette Qablawi

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1538666482
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
309751 Issued in NY
Practice address
230 W 17TH St
New York, NY 10011-5325
Phone
(212) 206-5200
Fax
(212) 206-5279
NPI assigned
Apr 8, 2018
Last updated
Jul 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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 309751 NY Primary

Addresses

Primary practice location

230 W 17TH St
New York, NY 10011-5325

Mailing address

307 Taft Ave
Cocoa Beach, FL 32931-3929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

677 Ala Moana Blvd
SPC 950
Honolulu, HI 96813-5408

Hospital & facility affiliations

National Provider Directory

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

Hospital & facility affiliations 1

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": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1538666482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 TAFT AVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115325",
            "telephone_number": "212-206-5200",
            "fax_number": "212-206-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QABLAWI",
        "first_name": "JEANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-08",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "309751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.