Individual provider Active NPI

Carol Christine Jagdeo, MD

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1114013554
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD14312 Issued in DC
Practice address
106 Irving Street, NW
Suite 406 S
Washington, DC 20010-2931
Phone
(202) 877-0535
Fax
(202) 877-9088
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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 MD14312 DC Primary

Addresses

Primary practice location

106 Irving Street, NW
Suite 406 S
Washington, DC 20010-2931

Mailing address

106 Irving Street, NW
Suite 406 South
Washington, DC 20010-2931
Phone (202) 877-0535

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080821000098 DC Practitioner - Internal Medicine 9335214618 Reassigns benefits to 1 organization
Practice locations: Washington, DC

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

106 Irving St NW 308
PMG_Gordon_Washington DC Office'
Washington, DC 20010-2927
Phone (202) 877-0400

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD14312DCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Aug 8, 2022 Accepting new patients
Privia Medical Group, LLC Internal Medicine CurrentSince Aug 8, 2022 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

106 Irving St NW
Ste S406
Washington, DC 20010

106 Irving St NW
Ste 406
Washington, DC 20010
Phone (202) 877-0510

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: carol.jagdeo.1@8042.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1114013554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 IRVING STREET, NW",
            "address_2": "SUITE 406 SOUTH",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102931",
            "telephone_number": "202-877-0535",
            "fax_number": "202-877-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 IRVING STREET, NW",
            "address_2": "SUITE 406 S",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102931",
            "telephone_number": "202-877-0535",
            "fax_number": "202-877-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGDEO",
        "first_name": "CAROL",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD14312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.