Bradley A Jabour, M.D.

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

A41876 Issued in CA

Practice address

2811 Wilshire Blvd Ste 810
Santa Monica, CA 90403-4812

Phone

(310) 829-9788

Fax

(310) 453-1576

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Diagnostic Radiology

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Imaging Center of Southern CaliforniaGroup PAC ID 2961306469, 7 clinicians

Medical Imaging Center of Southern California-Beverly Hills IncGroup PAC ID 6709133200, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Medical Imaging Center of Southern California-Beverly Hills, Inc

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1437641727
  Medicare reassignment Care Compare group NPD Authorized official
• Chroman TMS, Inc

  • Behavioral Neurology & Neuropsychiatry Physician
  • Santa Monica, CA
  • NPI 1154972933
  Medicare reassignment NPD Authorized official
• Medical Imaging Center of Southern California

  • Diagnostic Radiology Physician
  • Santa Monica, CA
  • NPI 1700907433
  Medicare reassignment Care Compare group NPD
• Directed Interventional Surgery Ctr Inc a Professional Medical Corp

  • Ambulatory Surgical Clinic/Center
  • Santa Monica, CA
  • NPI 1679694392
  NPD (past)
• Head and Neck Imaging Associates

  • Neuroradiology Physician
  • Santa Monica, CA
  • NPI 1184745820
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609997402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD STE 810",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034812",
            "telephone_number": "310-829-9788",
            "fax_number": "310-453-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD STE 810",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034812",
            "telephone_number": "310-829-9788",
            "fax_number": "310-453-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABOUR",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A41876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A418760",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00A418760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omi Iwasaki, PT, DPT, OCS, ATC
• Preetha Srinath Iyengar
• J & C Wellness LLC
• J David Edwards MD Inc
• J Ronald Rich MD Inc
• Gregory Scott Jack, M.D.
• Aaron Jackson
• Ashley Jackson, BA
• Candyce S Jackson
• Charlre-L E Jackson, AA

• Neuroradiology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Neuroradiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.