Individual provider Active NPI

David J Jagoda, M.D.

  • Internal Medicine Physician
  • Tempe, AZ
National Provider Identifier
1093706335
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25979 Issued in AZ
Practice address
2009 E 5TH St Ste 9
Ste 9
Tempe, AZ 85281-3067
Phone
(480) 237-9377
Fax
(480) 237-9377
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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 25979 AZ Primary

Addresses

Primary practice location

2009 E 5TH St Ste 9
Ste 9
Tempe, AZ 85281-3067

Mailing address

PO Box 841
Queen Creek, AZ 85142-1817
Phone (480) 237-9377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1093706335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421817",
            "telephone_number": "480-237-9377",
            "fax_number": "480-237-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 E 5TH ST STE 9",
            "address_2": "STE 9",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852813067",
            "telephone_number": "480-237-9377",
            "fax_number": "480-237-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGODA",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "25979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.