Individual provider Active NPI

Shagufta Jabeen, M.D

  • Family Medicine Physician
  • Kent, WA
National Provider Identifier
1649570631
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60675879 Issued in WA
Practice address
403 E Meeker St Ste 200
Kent, WA 98030-5904
Phone
(253) 852-2866
NPI assigned
Oct 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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 MD60675879 WA Primary

Addresses

Primary practice location

403 E Meeker St Ste 200
Kent, WA 98030-5904

Mailing address

955 Powell Ave SW
7531
Renton, WA 98057-2908
Phone (425) 277-1311

Other practice location 1

7531 S Stony Island Ave
7531
Chicago, IL 60649-3954
Phone (773) 947-7313

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address auburn.healthpoint.p3@direct.hpc.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20130507000237 OR Practitioner - Family Practice 4688845803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

12425 NE Glisan St
Portland, OR 97230-2144
Phone (503) 680-0075

12710 SE Division
Portland, OR 97236-3134
Phone (503) 988-3601

600 NE 8TH St
Gresham, OR 97030-7317
Phone (503) 988-7468

Hospital & facility affiliations

  • Adventist Health Portland Hospital, Portland, OR, CCN 380060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Sep 28, 2021 Accepting new patients
Multnomah County CurrentSince Sep 28, 2021 Accepting new patients
Multnomah County Current Accepting new patients
Southside Primary Care Group SC Family Medicine PastSince Feb 11, 2024 Accepting new patients
Rajiv Kandala M D S C Family Medicine PastSince Jun 27, 2021 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

12425 NE Glisan St
Portland, OR 97230
Phone (503) 252-3560

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

619 NW 6th Ave
Portland, OR 97209
Phone (503) 988-3674

Interoperability endpoints

  • Direct secure messaging: sjabeen358409@direct.ochin.org

Organizations & group practices 5

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 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": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1649570631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 POWELL AVE SW",
            "address_2": "7531",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572908",
            "telephone_number": "425-277-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E MEEKER ST STE 200",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305904",
            "telephone_number": "253-852-2866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7531 S Stony Island Ave",
            "address_2": "7531",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606493954",
            "country_code": "US",
            "telephone_number": "773-947-7313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JABEEN",
        "first_name": "SHAGUFTA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60675879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "auburn.healthpoint.p3@direct.hpc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "126 Auburn Ave Ste 300",
            "city": "Auburn",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980025082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.