Individual provider Active NPI

Jason Taniguchi, D.O.

  • Internal Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1245572155
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
308126 Issued in NY
Practice address
7300 S Raeford Rd
Fayetteville, NC 28304-6162
Phone
(910) 488-2120
NPI assigned
Mar 19, 2013
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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 308126 NY Primary

Addresses

Primary practice location

7300 S Raeford Rd
Fayetteville, NC 28304-6162

Mailing address

7300 S Raeford Rd
Fayetteville, NC 28304-6162
Phone (910) 488-2120

Other identifiers 1

IdentifierTypeStateIssuer
06474368MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210426000357 NY Practitioner - Internal Medicine 4385052794 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308126NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Family Healthcare CurrentSince Jan 22, 2021 Accepting new patients
Cornerstone Family Healthcare CurrentSince Jan 22, 2021 Accepting new patients

Locations

2570 US Highway 9W
Ste 10
Cornwall, NY 12518
Phone (845) 220-3100

10 Benton Ave
Middletown, NY 10940
Phone (845) 343-0881

147 Lake St
Newburgh, NY 12550

140 Hammond St
Port Jervis, NY 12771
Phone (845) 858-2854

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCECD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1245572155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 S RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283046162",
            "telephone_number": "910-488-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 S RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283046162",
            "telephone_number": "910-488-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANIGUCHI",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "308126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06474368",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.