Individual provider Active NPI

Sanjeev Bagga, M.D.

  • Diagnostic Radiology Physician
  • Little Rock, AR
National Provider Identifier
1124111398
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD065337L Issued in PA
Practice address
Central Arkansas Veterans Health Care System
4300 West 7TH Street
Little Rock, AR 72205-1000
Phone
(501) 257-1000
NPI assigned
Oct 2, 2006
Last updated
Jul 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X MD065337L PA
Diagnostic Radiology Physician 2085R0202X MD065337L PA Primary
Diagnostic Radiology Physician 2085R0202X C53626 CA

Addresses

Primary practice location

Central Arkansas Veterans Health Care System
4300 West 7TH Street
Little Rock, AR 72205-1000

Mailing address

Central Arkansas Veterans Health Care System
4300 West 7TH St
Little Rock, AR 72205-1000
Phone (501) 257-1000

Other identifiers 1

IdentifierTypeStateIssuer
1023711630002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 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
I20071126000573 FL Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 1355382045 Reassigns benefits to 1 organization
I20100128000270 NY Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 1355382045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Diagnostic Radiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-3407
Phone (631) 638-2121

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5400

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C53626CAMDDiagnostic Radiology Physician
MD065337LPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Physician Associates, PLLC CurrentSince Feb 15, 2023 Accepting new patients
Doctors Imaging Group LLC Nuclear Radiology CurrentSince Dec 24, 2019 Accepting new patients
Stony Brook Radiology, University Faculty Practice Corporation Diagnostic Radiology CurrentSince Apr 22, 2024 Accepting new patients
Brevard Physician Associates, PLLC Nuclear Radiology CurrentSince Feb 15, 2023 Accepting new patients
Florida Hospital Medical Group Inc Diagnostic Radiology PastSince Jun 4, 2008 Accepting new patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc Diagnostic Radiology Past Accepting new patients
FRG Acmh PC Diagnostic Radiology Past Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Nuclear Radiology Past Accepting new patients
Tolland Imaging Center, LLC Diagnostic Radiology Past Accepting new patients

Locations

6716 NW 11th Pl
Gainesville, FL 32605
Phone (352) 331-9829

6716 NW 11th Pl
Ste 200
Gainesville, FL 32605

1223 Gateway Dr
Melbourne, FL 32901
Phone (321) 549-0677

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

6121 Saint Johns Ave
Palatka, FL 32177
Phone (386) 326-0077

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Organizations & group practices 9

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1124111398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CENTRAL ARKANSAS VETERANS HEALTH CARE SYSTEM",
            "address_2": "4300 WEST 7TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051000",
            "telephone_number": "501-257-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRAL ARKANSAS VETERANS HEALTH CARE SYSTEM",
            "address_2": "4300 WEST 7TH STREET",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051000",
            "telephone_number": "501-257-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGGA",
        "first_name": "SANJEEV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "MD065337L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD065337L",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C53626",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023711630002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.