Individual provider Active NPI

Mohamed Mahmoud Jaber, M D

  • Diagnostic Radiology Physician
  • Detroit, MI
National Provider Identifier
1942598990
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301098779 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-5111
Fax
(313) 745-3500
NPI assigned
Jul 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DR.0056088 CO
Vascular & Interventional Radiology Physician 2085R0204X 4301098779 MI
General Practice Physician 208D00000X 4301098779 MI
Diagnostic Radiology Physician 2085R0202X 4301098779 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

4617 Allen Rd
Allen Park, MI 48101-2765
Phone (313) 779-8113

Other practice location 1

13001 E 17th Pl
Aurora, CO 80045-2570
Phone (303) 724-8882

Other practice location 2

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (855) 674-4624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL, NJ, IL4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20171208000344 MI Practitioner - Diagnostic Radiology 8123329364 Reassigns benefits to 11 organizations
I20250605001202 FL Practitioner - Diagnostic Radiology 8123329364 Reassigns benefits to 1 organization
I20250804003959 NJ Practitioner - Diagnostic Radiology 8123329364 Reassigns benefits to 1 organization
I20260326001893 IL Practitioner - Diagnostic Radiology 8123329364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

2900 Collins Rd
Lansing, MI 48910-8394
Phone (517) 975-7500

3990 John R St
Detroit, MI 48201-2018
Phone (313) 745-8040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0056088COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southfield Rehabilitation Company Diagnostic Radiology CurrentSince Oct 11, 2021 Accepting new patients
Mary Washington Healthcare Providers LLC Diagnostic Radiology CurrentSince Oct 25, 2025 Accepting new patients
Southfield Rehabilitation Company Diagnostic Radiology CurrentSince Oct 11, 2021 Accepting new patients
McLaren Central Michigan CurrentSince Aug 13, 2025 Accepting new patients
Prime Radiology Consultants P.C. Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
McLaren Flint CurrentSince Aug 13, 2025 Accepting new patients
Kellam & Associates, P. C. Diagnostic Radiology CurrentSince Mar 19, 2018 Accepting new patients
McLaren Hospital Group Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
VHS Physicians of Michigan CurrentSince Apr 15, 2025 Accepting new patients
McLaren Central Michigan CurrentSince Aug 13, 2025 Accepting new patients
Millennium Physician Group LLC CurrentSince May 1, 2025 Accepting new patients
McLaren Central Michigan Current Accepting new patients
McLaren Bay Region CurrentSince Aug 14, 2025 Accepting new patients
McLaren Flint Diagnostic Radiology CurrentSince Aug 13, 2025 Accepting new patients
Southwest Medical Associates, Inc CurrentSince May 1, 2025 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince May 10, 2025 Accepting new patients
McLaren Bay Region CurrentSince Aug 14, 2025 Accepting new patients
Millennium Physician Group LLC CurrentSince May 1, 2025 Accepting new patients
Pain Therapy Associates LTD. General Practice Past Accepting new patients
Southwest Medical Associates Inc. Past Accepting new patients
Advanced Radiology Services PC Diagnostic Radiology Past Accepting new patients

Locations

13813 Metro Pkwy
Fort Myers, FL 33912
Phone (239) 936-1343

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

7619 Solutions Ctr
Chicago, IL 60677

937 N Opdyke Rd
Auburn Hills, MI 48326
Phone (248) 373-7600

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

4 Columbus Ave
Ste 160
Bay City, MI 48708
Phone (989) 377-4477

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

10090 E Lippincott Blvd
Davison, MI 48423
Phone (810) 653-1130

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1320 E M 32
Gaylord, MI 49735
Phone (231) 487-5400

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

1375 N Main St
Lapeer, MI 48446
Phone (810) 667-5500

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

11012 E 13 Mile Rd
Ste 111
Warren, MI 48093
Phone (586) 558-8470

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1708/brand/1/csg/1/fhir/r4

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 5

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": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1942598990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012765",
            "telephone_number": "313-779-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-5111",
            "fax_number": "313-745-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 E 17th Pl",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452570",
            "country_code": "US",
            "telephone_number": "303-724-8882",
            "fax_number": "303-724-8882",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13813 Metro Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124343",
            "country_code": "US",
            "telephone_number": "855-674-4624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JABER",
        "first_name": "MOHAMED",
        "middle_name": "MAHMOUD",
        "name_prefix": "Dr.",
        "credential": "M D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-12",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0056088",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4301098779",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301098779",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301098779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.