Individual provider Active NPI

Mallory Jebbia, MD

  • Surgery Physician
  • Orange, CA
National Provider Identifier
1609396555
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A157063 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-5000
NPI assigned
Jun 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A157063 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

333 City Blvd W Ste 1600
Orange, CA 92868-5903

Other practice location 1

316 S Stratford Ave Ste B
Santa Maria, CA 93454-5908
Phone (805) 332-8446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230620002389 CA Practitioner - General Surgery 4183010408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Drexel University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgeons of Orange a Medical GroupGroup PAC ID 6901705227, 116 clinicians
Desert Trauma Surgeons IncGroup PAC ID 0547366106, 36 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 634-5549

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (310) 900-8900

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
97.68
Improvement activities
40
Cost
62.65

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157063CAMDSurgery Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
University Surgeons of Orange a Medical Group Surgery CurrentSince Aug 1, 2023 Accepting new patients
Desert Trauma Surgeons, Inc. CurrentSince Sep 23, 2024 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mjebbia60597@cityofhope.direct-ci.com

Organizations & group practices 3

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1609396555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD W STE 1600",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "316 S Stratford Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934545908",
            "country_code": "US",
            "telephone_number": "805-332-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEBBIA",
        "first_name": "MALLORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A157063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.