NPIMap

Individual provider Active NPI

Mandar R Jagtap, D.O.

  • Cardiovascular Disease Physician
  • Corinth, MS
National Provider Identifier
1255560918
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25097 Issued in MS
Practice address
1310 Highway 72 E
Corinth, MS 38834-6524
Phone
(662) 594-4123
Fax
(625) 942-2966
NPI assigned
Jul 2, 2009
Last updated
Jul 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X OS13840 FL
Cardiovascular Disease Physician 207RC0000X 25097 MS Primary

Addresses

Primary practice location

1310 Highway 72 E
Corinth, MS 38834-6524

Mailing address

PO Box 1470
Corinth, MS 38835-1470
Phone (662) 287-5218

Other identifiers 2

IdentifierTypeStateIssuer
03005201MedicaidMS
1H1365OtherMSMS MEDICARE INDIVIDUAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jagtapcardiology@magnolia.medalliesdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171003004454 MS Practitioner - Internal Medicine 4688966435 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tippah County HospitalGroup PAC ID 5193746709, shared by 6 NPIs, 24 clinicians
Magnolia Regional Health CenterGroup PAC ID 9739078460, 15 clinicians

Practice addresses (Care Compare)

100 Hospital St
Booneville, MS 38829-3354
Phone (662) 720-5000

1005 -A City Ave N
Ripley, MS 38663-1414
Phone (662) 837-9221

1009 Hwy 72 E
Corinth, MS 38834-6450
Phone (317) 201-2307

611 Alcorn Dr
Corinth, MS 38834-9321
Phone (662) 293-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting75
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS13840FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center CurrentSince Nov 1, 2017 Accepting new patients
Prime Heart and Vascular Care Cardiovascular Disease CurrentSince Nov 15, 2020 Accepting new patients
Tippah County Hospital CurrentSince Nov 15, 2020 Accepting new patients
Tippah County Hospital Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Baptist Memorial Hospital-Booneville, Inc. CurrentSince Jun 5, 2021 Accepting new patients
Northeast Ms Internal Medicine PC CurrentSince Nov 1, 2019 Accepting new patients
Magnolia Regional Health Center Cardiovascular Disease CurrentSince Nov 1, 2017 Accepting new patients
Baptist Memorial Hospital-Booneville, Inc. CurrentSince Jun 5, 2021 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Tippah County Hospital CurrentSince Nov 15, 2020 Accepting new patients
Tippah County Hospital CurrentSince Nov 15, 2020 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Stern Cardiovascular Foundation, Inc Cardiovascular Disease PastSince Nov 15, 2020 Accepting new patients

Locations

100 Hospital St
Booneville, MS 38829
Phone (662) 720-5000

202 N 1st St
Ste A
Booneville, MS 38829
Phone (662) 340-1138

369 Highway 72
Burnsville, MS 38833
Phone (662) 279-2077

1009 Highway 72 E
Corinth, MS 38834
Phone (317) 201-2307

1310 Highway 72 E
Corinth, MS 38834
Phone (317) 201-2307

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

611 Alcorn Dr
Ste 230
Corinth, MS 38834
Phone (662) 287-5218

1005 City Ave N
Ripley, MS 38663
Phone (601) 837-9221

1005 City Ave N
#A
Ripley, MS 38663
Phone (662) 837-2202

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/tippah-ba3c06de
  • Direct secure messaging: mandarjagtap@magnolia.medalliesdirect.net

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 9

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1255560918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1470",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388351470",
            "telephone_number": "662-287-5218",
            "fax_number": "662-286-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HIGHWAY 72 E",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346524",
            "telephone_number": "662-594-4123",
            "fax_number": "625-942-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGTAP",
        "first_name": "MANDAR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "OS13840",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "25097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03005201",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS MEDICARE INDIVIDUAL",
            "identifier": "1H1365",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jagtapcardiology@magnolia.medalliesdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Message Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1310 Highway 72 E",
            "city": "Corinth",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388346524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.