Jyothi Jagadeesh, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA08430600 Issued in NJ

Practice address

175 Madison Ave
Mount Holly, NJ 08060-2038

Phone

(609) 914-6180

Fax

(609) 914-6182

NPI assigned

May 29, 2007

Last updated

Sep 9, 2010By the provider in NPPES

Sex

Female

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

Other names 1

• Jyothi Sundar Former name

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Internal MedicineAlso: Geriatric Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlantic Visiting Nurse Hospice, Morristown, NJ, CCN 311503
• Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment Care Compare group NPD
• Hospitalist Physicians of New Jersey PA

  • Hospitalist Physician
  • Edison, NJ
  • NPI 1588021851

  Internal Medicine

  Medicare reassignment NPD
• Ipc Hospitalist Physicians of New Jersey PC

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1639303159
  Medicare reassignment NPD
• Ipc Hospitalist Physicians of New Jersey PC

  • Internal Medicine Physician
  • Vineland, NJ
  • NPI 1013141423
  NPD
• Ahs Hospital Corp.

  dba Chilton Medical Center

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  NPD (past)
• Virtua Surgical Group, P.a

  • Surgery Physician
  • Cherry Hill, NJ
  • NPI 1184811945
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hospital Corp.

  dba Atlantic Home Care & Hospice

  • Community Based Hospice Care Agency
  • Morristown, NJ
  • NPI 1144324765
  Care Compare affiliation
• Ahs Hospital Corp.

  dba Chilton Medical Center

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  Care Compare affiliation

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1053512269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N",
            "address_2": "40 LAKE CENTER DRIVE STE 201A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533425",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVE",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602038",
            "telephone_number": "609-914-6180",
            "fax_number": "609-914-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGADEESH",
        "first_name": "JYOTHI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08430600",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "390200000X",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175471",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JYOTHI",
            "last_name": "SUNDAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mohammed Nazrul Islam, M.D.
• J & B Rosolia Inc (Mount Holly Surgical Supply)
• Barbara Jachimowicz, APRN
• Olga E. Jackson, MD
• Jonathan Douglas Jaffe, D.O.
• James E. Rockwell DMD PA
• Candace C Jennings, CRNA
• Petra Johnson-Fontus
• Catherine Johnson, PCA
• Jane Nicole Johnson, APRN ANP-C

• Internal Medicine Physician in Mount Holly, NJ
• Providers in Mount Holly, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.