Individual provider Active NPI

Jordan Anne Stabinski, M.D.

  • Anesthesiology Physician
  • Brookline, MA
National Provider Identifier
1841495439
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
28948 Issued in OK
Practice address
152 Harvard St
Unit #6
Brookline, MA 02446
Phone
(317) 213-4840
NPI assigned
Jun 15, 2007
Last updated
May 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 11013306 IN
Anesthesiology Physician 207L00000X 28948 OK Primary

Addresses

Primary practice location

152 Harvard St
Unit #6
Brookline, MA 02446

Mailing address

PO Box 840848
Dallas, TX 75284-0848
Phone (972) 715-5000

Other practice location 1

152 Harvard St
Unit #6
Brookline, MA 02446-6477
Phone (317) 213-4840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20120816000789 OK Practitioner - Anesthesiology 7214119163 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11013306INMDAnesthesiology Physician
28948OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Sep 1, 2012 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Sep 1, 2012 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

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.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1841495439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840848",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840848",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 HARVARD ST",
            "address_2": "UNIT #6",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02446",
            "telephone_number": "317-213-4840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "152 Harvard St",
            "address_2": "Unit #6",
            "address_purpose": "LOCATION",
            "city": "Brookline",
            "state": "MA",
            "postal_code": "024466477",
            "country_code": "US",
            "telephone_number": "317-213-4840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STABINSKI",
        "first_name": "JORDAN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "11013306",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "28948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.