Ebaa A. Jastaniah, M.D., M.P.H

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E-13378 Issued in AR

Practice address

1 Childrens Way # 653
Little Rock, AR 72202-3500

Phone

(501) 364-1100

NPI assigned

May 1, 2014

Last updated

Sep 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arkansas Childrens Hospital

  dba ACH Physicians Billing Group

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1598773079
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  dba Childrens University Medical Group

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1346230968
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016

  Pediatrics

  Medicare reassignment NPD
• Arkansas Children's Hospital

  • Children's Hospital
  • Little Rock, AR
  • NPI 1477561983
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  dba CUMG Psychology Services

  • Psychologist
  • Little Rock, AR
  • NPI 1114255353
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1871655050
  NPD

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1760892566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 High Street",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011091442",
            "country_code": "US",
            "telephone_number": "413-794-5084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASTANIAH",
        "first_name": "EBAA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-01",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-13378",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Jarrett, RN
• Dasija Jarrett
• Tanner Milam Jarrett, MD
• Robert M Jarvis, MD
• Sarah D Jarvis
• Kewen Z Jauss, M.D.
• Hafiz Talha Javed, MD
• Herra Javed, MBBS
• Muhammad Jawad Javed, MD
• Amna Jawaid, MD

• Pediatrics Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.