Jamil Abou-Harb, MD
Individual provider Active NPI Pediatric Gastroenterology Physician · Spokane, WA
NPI 1891712980 · NPPES record last updated Apr 9, 2021
Key facts
- NPI
- 1891712980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Gastroenterology Physician 2080P0206X
- License
- MD00046191 (WA)
- Practice address
- 105 W 8TH Ave
Suite 150E
Spokane, WA 99204-2302 - Phone
- (509) 474-5437
- Fax
- (509) 474-5438
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Providence Health and Services Washington
Practice addresses (Care Compare)
105 W 8TH Ave
Spokane, WA 99204-2327
1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061005000581 | WA | Practitioner - Pediatric Medicine |
5193721611 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Washington | Current |
Accepting new patients | |
| Providence Health & Services Washington | Current |
Accepting new patients | |
| Providence Health & Services - Washington | Past | Accepting new patients |
Locations
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
105 W 8th Ave
Ste 150E
Spokane, WA 99204
Phone (509) 252-1704
105 W 8th Ave
Ste 7060
Spokane, WA 99204
Phone (509) 474-5437
105 W 8th Ave
Ste 6045
Spokane, WA 99204
Phone (509) 455-3676
Interoperability endpoints
- jabouharb214273@wm.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | MD00046191 | WA | Yes |
Addresses
Primary practice location
105 W 8TH Ave
Suite 150E
Spokane, WA 99204-2302
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 474-2072
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0210345 | Other | WA | L&I NUMBER |
| 807484200 | Other | WA | IDAHO MEDICAID |
| 8459646 | Other | WA | WA MEDICAID |
| GAB32999 | Other | WA | MEDICARE GROUP |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jabouharb214273@wm.providencedirect.org | Direct |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.