Individual provider Active NPI

Jagat Bandhu Mahat, MD

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1033728118
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
100797 Issued in GA
Practice address
827 Linden Ave
Baltimore, MD 21201-4606
Phone
(410) 225-8790
NPI assigned
Jul 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 100797 GA Primary

Addresses

Primary practice location

827 Linden Ave
Baltimore, MD 21201-4606

Mailing address

827 Linden Ave
Baltimore, MD 21201-4606
Phone (410) 225-8790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240711001207 GA Practitioner - Internal Medicine 5799220026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Apogee Medical Group GeorgiaGroup PAC ID 4587676945, 122 clinicians

Practice addresses (Care Compare)

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 333-1000

Hospital & facility affiliations

  • SGMC Health Hospital, Valdosta, GA, CCN 110122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100797GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Georgia Internal Medicine CurrentSince Jul 2, 2024 Accepting new patients
South Georgia Medical Center Inc Student in an Organized Health Care Education/Training Program Past Accepting new patients

Locations

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1033728118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 LINDEN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014606",
            "telephone_number": "410-225-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 LINDEN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014606",
            "telephone_number": "410-225-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAT",
        "first_name": "JAGAT",
        "middle_name": "BANDHU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-24",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "100797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.