JABBAR FAZELI (NPI# 1649363805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649363805 |
| Entity Type | Individual |
| Full Name | JABBAR FAZELI |
| Credential | MD |
| Practice Address |
1321 Washington Ave Suite 310 Portland ME 04103-3636 |
| Practice Telephone | 2077806565 |
| Practice Fax Number | 2078786565 |
| Mailing Telephone | 2077806565 |
| Mailing Fax Number | 2078786565 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2014-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
015513 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 227900099 | 05 |
| Street Address |
1321 WASHINGTON AVE SUITE 310 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-3636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902850589 | Longview Psychotherapy PC | Social Worker | 1321 Washington Ave, Suite 304, Portland, ME 04103-3636 | 2006-05-19 |
| 1528502002 | Kristen Mickkelsen Pmhnp Bc LLC | Nurse Practitioner | 1321 Washington Ave, Suite 304, Portland, ME 04103-3636 | 2016-12-19 |
| 1578958294 | Jada L Kouba | Counselor | 1321 Washington Ave, Suite 312, Portland, ME 04103-3636 | 2015-03-31 |
| 1710399506 | Michelle Atienza | Nurse Practitioner | 1321 Washington Ave, Portland, ME 04103-3636 | 2014-05-28 |
| 1659782993 | Sean Murphy | Chiropractor | 1321 Washington Ave, Suite 212, Portland, ME 04103-3636 | 2014-05-08 |
| 1568872802 | Daly Grace Pa | Chiropractor | 1321 Washington Ave, Suite 212, Portland, ME 04103-3636 | 2014-05-07 |
| 1518304872 | Dialectical and Cognitive Behavioral Therapy of Nh, Pllc | Community/Behavioral Health | 1321 Washington Ave, Suite 304, Portland, ME 04103-3636 | 2013-05-28 |
| 1497096051 | Jennifer A Blanchette | Psychologist | 1321 Washington Ave, Portland, ME 04103-3654 | 2013-03-07 |
| 1336484369 | Yvonne L. Decory M.d., P.a. | Psychiatry & Neurology | 1321 Washington Ave, Suite 304, Portland, ME 04103-3636 | 2012-12-03 |
| 1407150303 | Lauren Herdrich | Counselor | 1321 Washington Ave, Portland, ME 04103-3636 | 2011-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
| 1093916470 | Kellie Rooney Foster | Internal Medicine | 2710 Nw Vaughn St, Suite 160, Portland, OR 97210-5344 | 2007-05-31 |
| 1447310859 | Karen Kruse | Internal Medicine | 8200 Se Barbara Welch Rd, Portland, OR 97236-5335 | 2006-12-08 |
| 1083729214 | Stephen Arnold Ebert | Internal Medicine | 2701 Nw Vaughn St., Suite 160, Portland, OR 97201 | 2006-08-20 |
| 1609892736 | Paul Gowen | Internal Medicine | 3635 Ne Alameda St, Portland, OR 97212-1812 | 2006-07-14 |
| 1669418810 | Douglas Reed Grossnickle | Internal Medicine | 10373 Ne Hancock, Suite 219, Portland, OR 97220 | 2006-06-22 |
| 1457324949 | George Goodstein | Internal Medicine | 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239-6102 | 2006-02-07 |
| 1497757447 | Luis Felipe Rodriguez | Internal Medicine | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2005-08-10 |
| 1518372606 | Paul R Porter Md | Internal Medicine | 934 S Broadway St, Ste 3, Portland, TN 37148-1700 | 2014-06-26 |
| 1093128571 | Lisa Kendell Sanders | Internal Medicine | 5050 Ne Hoyt St Ste 540, Portland, OR 97213 | 2014-06-03 |
| 1457642373 | Sandhya Venkata Srikantom | Internal Medicine | 3710 Sw Us Veterans Hospital Rd, Attn P3med, Portland, OR 97239-2964 | 2011-04-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.