Jyoti S Datta MD Inc

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

A33096 Issued in CA

Legal business name

JYOTI S DATTA MD INC

Practice address

1045 Atlantic Ave Ste 616
Long Beach, CA 90813-3411

Phone

(562) 435-4473

Fax

(562) 437-6937

NPI assigned

Apr 27, 2017

Last updated

May 8, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jeannie C Savage

Title

Office Manager

Phone

(562) 435-4473

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jyoti S Datta, MD

  • Pulmonary Disease Physician
  • Long Beach, CA
  • NPI 1568535615
  Medicare reassignment NPD

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1033644075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE STE 616",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133411",
            "telephone_number": "562-435-4473",
            "fax_number": "562-437-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE STE 616",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133411",
            "telephone_number": "562-435-4473",
            "fax_number": "562-437-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JYOTI S DATTA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "SAVAGE",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "562-435-4473",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A33096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A330960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.