Organization Active NPI

Morris Jagodowicz MD Inc

  • Anesthesiology Physician
  • Northridge, CA
National Provider Identifier
1184685489
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A34110 Issued in CA
Legal business name
MORRIS JAGODOWICZ MD INC
Practice address
18300 Roscoe Blvd
Northridge, CA 91325-4105
Phone
(818) 885-8500
Fax
(818) 715-1722
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Authorized official

Name
Morris Jagodowicz, M.D.NPI 1184699308
Title
Direct Owner
Phone
(818) 888-7815

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X A34110 CA Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X A34110 CA

Addresses

Primary practice location

18300 Roscoe Blvd
Northridge, CA 91325-4105

Mailing address

PO Box 7001
Tarzana, CA 91357-7001
Phone (818) 888-7815

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090129000127 CA Part B Supplier - Clinic/Group Practice 6507920949 Receives reassigned benefits from 1 practitioner
Practice locations: Granada Hills, CA; Northridge, CA

National Provider Directory

National Provider Directory

Locations

10515 Balboa Blvd
Ste 390
Granada Hills, CA 91344
Phone (818) 366-8112

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1184685489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7001",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913577001",
            "telephone_number": "818-888-7815",
            "fax_number": "818-715-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254105",
            "telephone_number": "818-885-8500",
            "fax_number": "818-715-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRIS JAGODOWICZ MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "JAGODOWICZ",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "818-888-7815",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A34110",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A34110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.