Individual provider Active NPI

Mithulan Jegapragasan, MD

  • Hospitalist Physician
  • Rochester, MN
National Provider Identifier
1063711497
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DR.0064418 Issued in CO
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Mar 24, 2011
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 58365 MN
Orthopaedic Surgery Physician 207X00000X ML60225427 WA
Hospitalist Physician 208M00000X 58365 MN
Hospitalist Physician 208M00000X DR.0064418 CO Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

501 E Hampden Ave
Englewood, CO 80113-2702

Other practice location 1

200 Exempla Cir
Lafayette, CO 80026-3370
Phone (303) 338-4545

Other identifiers 1

IdentifierTypeStateIssuer
029134OtherCOKAISER COMMERCIAL NUMBER

Other names 1

  • Mith Jegapragasan Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190222000660 TX Practitioner - Internal MedicinePractitioner - Hospitalist 2062638646 Reassigns benefits to 1 organization
I20200811001210 CO Practitioner - HospitalistPractitioner - Internal Medicine 2062638646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Pittsburgh School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

200 Emempla Circle
KP Intermountain Health Good Samaritan Hosp
Lafayette, CO 80026-3370
Phone (303) 338-4545

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML60225427WAMDOrthopaedic Surgery Physician
DR.0064418COMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Orthopaedic Surgery CurrentSince Jan 4, 2019 Accepting new patients
Colorado Permanente Medical Group, P.C. Internal Medicine CurrentSince Nov 9, 2020 Accepting new patients
Baylor College of Medicine Internal Medicine CurrentSince Jan 4, 2019 Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

200 Exempla Cir
Lafayette, CO 80026
Phone (303) 689-4110

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

6720 Bertner Ave
Ste O520
Houston, TX 77030
Phone (832) 355-2202

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1063711497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E HAMPDEN AVE",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Exempla Cir",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800263370",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEGAPRAGASAN",
        "first_name": "MITHULAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "58365",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "ML60225427",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "58365",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0064418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029134",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "200 Exempla Cir",
            "city": "Lafayette",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800263370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MITH",
            "last_name": "JEGAPRAGASAN",
            "credential": "NICKNAME",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.