Individual provider Active NPI

Mustafa Adnan Al-Jubouri, M.D.

  • Surgery Physician
  • Toledo, OH
National Provider Identifier
1780926287
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35.137067 Issued in OH
Practice address
2109 Hughes Dr Ste 220
Toledo, OH 43606-5121
Phone
(419) 291-5150
Fax
(419) 479-6173
NPI assigned
Mar 22, 2013
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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 35.137067 OH Primary

Addresses

Primary practice location

2109 Hughes Dr Ste 220
Toledo, OH 43606-5121

Mailing address

2109 Hughes Dr Ste 220
Toledo, OH 43606-5121
Phone (419) 291-5150

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address maljubouri14125@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20191119002519 OH Practitioner - General Surgery 6305140922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 220
Toledo, OH 43606-5121
Phone (419) 291-5150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35137067OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Toledo Hospital Surgery CurrentSince Oct 1, 2019 Accepting new patients
Promedica Central Physicians Surgery CurrentSince Oct 1, 2019 Accepting new patients
The Toledo Hospital Current Accepting new patients
Promedica Central Physicians CurrentSince Oct 1, 2019 Accepting new patients
The Toledo Hospital CurrentSince Oct 1, 2019 Accepting new patients

Locations

2751 Bay Park Dr
Ste 303
Oregon, OH 43616
Phone (419) 690-7676

5700 Monroe St
Unit 106
Sylvania, OH 43560
Phone (419) 885-2525

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 220
Toledo, OH 43606
Phone (419) 291-5150

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

Interoperability endpoints

  • Direct secure messaging: maljubouri14125@direct.promedica.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1780926287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 HUGHES DR STE 220",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065121",
            "telephone_number": "419-291-5150",
            "fax_number": "419-479-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 HUGHES DR STE 220",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065121",
            "telephone_number": "419-291-5150",
            "fax_number": "419-479-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-JUBOURI",
        "first_name": "MUSTAFA",
        "middle_name": "ADNAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-22",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.137067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maljubouri14125@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "2109 Hughes Dr Ste 220",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436065121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.