Mohammad Jalal Tabbah, M.D

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

4301060157 Issued in MI

Practice address

G1125 S Linden Rd Ste 500
Flint, MI 48532

Phone

(810) 262-2140

Fax

(810) 230-3942

NPI assigned

Mar 9, 2007

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, CA2 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

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 and National Provider Directory roles.

• Hurley Medical Center

  • Obstetrics & Gynecology Physician
  • Flint, MI
  • NPI 1982630844
  Medicare reassignment NPD
• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  Medicare reassignment NPD
• Hurley Medical Center

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1427092998
  NPD
• Hurley Medical Center

  • Plastic and Reconstructive Surgery Physician
  • Flint, MI
  • NPI 1689345761
  NPD
• Hurley Medical Center

  • Pediatrics Physician
  • Flint, MI
  • NPI 1821024910
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1891826772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLAZA ATTN PROFESSIONAL BILLING DEPT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G1125 S LINDEN RD STE 500",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48532",
            "telephone_number": "810-262-2140",
            "fax_number": "810-230-3942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 California St Ste B555",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94118",
            "country_code": "US",
            "telephone_number": "650-497-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABBAH",
        "first_name": "MOHAMMAD",
        "middle_name": "JALAL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "C156135",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301060157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891826772",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtabbah16051@direct.hurleymc.com",
            "affiliation": "N",
            "address_1": "G1125 S Linden Rd Ste 500",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Szostak, LMSW
• Paul Szpunar, LLMSW
• Christopher S Szyarto, D.O.
• Angela Suzanne Szymanski, DDS
• T W Eason OD PC
• Steven Courter Taft, D.D.S.
• Isam Tahboub, R.PH., M.S.
• Qurat Ul Ain Tahir
• Tai K. Kang, M.D., P.C.
• Keinan Taja

• Pediatric Gastroenterology Physician in Flint, MI
• Providers in Flint, MI by specialty
• Pediatric Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.