NPIMap

Individual provider Active NPI

Jagdish Kumar Sachdeva, MD

  • Internal Medicine Physician
  • Southgate, MI
National Provider Identifier
1295891067
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
JS033632 Issued in MI
Practice address
15105 Northline Rd
Southgate, MI 48195
Phone
(734) 283-4122
Fax
(734) 282-7577
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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 JS033632 MI Primary

Addresses

Primary practice location

15105 Northline Rd
Southgate, MI 48195

Mailing address

15105 Northline Rd
Southgate, MI 48195
Phone (734) 283-4122

Other identifiers 1

IdentifierTypeStateIssuer
1848773MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120207000531 MI Practitioner - Internal Medicine 0840361853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine Assoc of Mi PCGroup PAC ID 9335219567, 3 clinicians

Practice addresses (Care Compare)

15105 Northline Rd
Southgate, MI 48195-2409
Phone (734) 282-7734

Hospital & facility affiliations

  • Beaumont Home Health Home health agency, Troy, MI, CCN 237112
  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270
  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JS033632MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Assoc of Mi PC Internal Medicine CurrentSince Apr 9, 1991 Accepting new patients

Locations

25880 Outer Dr
Lincoln Park, MI 48146
Phone (313) 294-9410

15105 Northline Rd
Southgate, MI 48195
Phone (734) 282-7734

Interoperability endpoints

  • Direct secure messaging: jsachdeva58959@direct.hfhs.org
  • Direct secure messaging: jagdish.sachdeva@imaom.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IFFDAD/Endpoint/IFFDAD

Organizations & group practices 1

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 8

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1295891067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15105 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "48195",
            "telephone_number": "734-283-4122",
            "fax_number": "734-282-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15105 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "48195",
            "telephone_number": "734-283-4122",
            "fax_number": "734-282-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHDEVA",
        "first_name": "JAGDISH",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "JS033632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1848773",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.