Jairus Tesorero Ibabao, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

193284 Issued in NY

Practice address

21 Porter Ave
Jamestown, NY 14701-6247

Phone

(716) 664-1909

Fax

(716) 664-2214

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Medical OncologyAlso: Hematology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239
• Roswell Park Cancer Institute Hospital, Buffalo, NY, CCN 330354

Merit-based Incentive Payment System (MIPS)

Final score

30.93 of 100Reported as individual

Quality

39.59

Promoting interoperability

0

Improvement activities

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Saif Soniwala,M.D.,PC

  • Hematology & Oncology Physician
  • Williamsville, NY
  • NPI 1114061942
  NPD
• Oncology Medical and Surgical Supplies, LLC

  • Durable Medical Equipment & Medical Supplies
  • Jamestown, NY
  • NPI 1346486388
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Roswell Park Cancer Institute

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1548315401
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jamestown, NY
  • NPI 1568023687
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • General Acute Care Hospital
  • Jamestown, NY
  • NPI 1770573222
  Care Compare affiliation

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1568465458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 ORCHARD PARK RD STE C",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271238",
            "telephone_number": "716-674-3104",
            "fax_number": "716-674-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PORTER AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016247",
            "telephone_number": "716-664-1909",
            "fax_number": "716-664-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBABAO",
        "first_name": "JAIRUS",
        "middle_name": "TESORERO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "193284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "714714",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "005244934",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7200341",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "830006548",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "10352702",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0191329",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "1294660001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01830340",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan W Hulbert, LCSW
• Marissa Hull
• Patricia A Humm, LCSW
• Joan B. Huston, PH.D.
• Karolee Hutchinson, PTA
• Osaze Batholomew Ibhawa
• Kevin Matthew Intrieri, MD
• Katie Ireland
• Doreen Iula, GNP
• Seth Henry Iverson, MD

• Hematology & Oncology Physician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Hematology & Oncology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.