NPIMap

Organization Active NPI

Jackson Cardiology Consultants PLLC

  • Interventional Cardiology Physician
  • Jackson, MI
National Provider Identifier
1053970624
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
JACKSON CARDIOLOGY CONSULTANTS PLLC
Practice address
205 Page Ave
Jackson, MI 49201-2462
Phone
(517) 787-3577
Fax
(517) 787-4280
NPI assigned
Jun 7, 2019
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Tareq Baghal, MDNPI 1255332490
Title
Owner
Phone
(517) 787-3577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X Primary

Addresses

Primary practice location

205 Page Ave
Jackson, MI 49201-2462

Mailing address

205 Page Ave Ste B
Jackson, MI 49201-2462
Phone (517) 787-3577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190703002083 MI Part B Supplier - Clinic/Group Practice 0042545535 Receives reassigned benefits from 15 practitioners
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1053970624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PAGE AVE STE B",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012462",
            "telephone_number": "517-787-3577",
            "fax_number": "517-787-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PAGE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012462",
            "telephone_number": "517-787-3577",
            "fax_number": "517-787-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CARDIOLOGY CONSULTANTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-07",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "BAGHAL",
        "authorized_official_first_name": "TAREQ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-787-3577",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.