NPIMap

Organization Active NPI

Jagannathan Neurosurgical Institute PLLC

  • Neurological Surgery Physician
  • Mt Pleasant, MI
National Provider Identifier
1093521080
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
JAGANNATHAN NEUROSURGICAL INSTITUTE PLLC
Practice address
1221 South Dr
Mount Pleasant, MI 48858-3257
Phone
(989) 308-1840
Fax
(989) 391-4170
NPI assigned
Dec 5, 2024
Last updated
Dec 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Jayant JagannathanNPI 1558578708
Title
President
Phone
(248) 733-9904

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
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

1221 South Dr
Mount Pleasant, MI 48858-3257

Mailing address

Dept 771749 PO Box 77000
Detroit, MI 48277
Phone (989) 308-1840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250428000976 MI DME Supplier - Physician - Neurology 9638317373 Practice locations: Mount Pleasant, MI

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

2050 N Haggerty Rd
Canton, MI 48187
Phone (240) 350-7683

215 E Big Beaver Rd
Ste 400
Troy, MI 48083
Phone (248) 435-0925

3290 W Big Beaver Rd
Ste 150
Troy, MI 48084
Phone (248) 792-6527

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1093521080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 771749 PO BOX 77000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48277",
            "telephone_number": "989-308-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 SOUTH DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488583257",
            "telephone_number": "989-308-1840",
            "fax_number": "989-391-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAGANNATHAN NEUROSURGICAL INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "JAGANNATHAN",
        "authorized_official_first_name": "JAYANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-733-9904"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.