Jeannette Lia Gaggino, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301405993 Issued in MI

Practice address

121 Bulkley St
Kalamazoo, MI 49006-3262

Phone

(269) 385-4701

NPI assigned

Jan 25, 2006

Last updated

Jan 25, 2023By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

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.

• Bronson Methodist Hospital

  dba Bronson Medical Group

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment NPD

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1093785560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BULKLEY ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490063262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BULKLEY ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490063262",
            "telephone_number": "269-385-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGGINO",
        "first_name": "JEANNETTE",
        "middle_name": "LIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301405993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4467369",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randi Gabrielsen
• Kimberlee Therese Gabrielson, DNP, FNP
• Esther Gachiri
• Akshaya Gadre, MD
• Rebecca Gage
• Mikaela Gagnier
• Jennifer Maria Gago
• Claire Lynn Gaillard, CMT, MA
• Nilanjan B Gajare, M.D.
• Aparna Gaje

• Pediatrics Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.