Jaishankar Jagadeesan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15442 Issued in MS

Practice address

972 Columbia Ave
Prentiss, MS 39474

Phone

(601) 792-3200

Fax

(601) 792-3299

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Internal Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Davis Community Hospital Cah Hospital, Prentiss, MS, CCN 251326
• Magee General Hospital Hospital, Magee, MS, CCN 250124
• Marion General Hospital Hospital, Columbia, MS, CCN 250085

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13169/brand/1/csg/1/fhir/r4
• Direct secure messaging: jaishankar.jagadeesan.1@13169.direct.athenahealth.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: dr.jay@ppcp-ms.direct.office.nextgen.com

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.

• Prentiss Primary Care, P.a.

  • Internal Medicine Physician
  • Prentiss, MS
  • NPI 1902129455

  Internal Medicine, MS

  Medicare reassignment NPD Authorized official
• Independent Healthcare Management, Inc.

  • Critical Access Hospital
  • Forest, MS
  • NPI 1306909734
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forrest County General Hospital

  • Critical Access Hospital
  • Prentiss, MS
  • NPI 1295013316

  Hospital

  Care Compare affiliation
• Forrest County General Hospital

  • General Acute Care Hospital
  • Columbia, MS
  • NPI 1427320993

  Hospital

  Care Compare affiliation
• Magee Benevolent Association

  • General Acute Care Hospital
  • Magee, MS
  • NPI 1679553994

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1326149253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1373",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394741373",
            "telephone_number": "601-792-3200",
            "fax_number": "601-792-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 COLUMBIA AVE",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "39474",
            "telephone_number": "601-792-3200",
            "fax_number": "601-792-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGADEESAN",
        "first_name": "JAISHANKAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016230",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ashley Kirby Ware, DNP
• William Lewis, PCMHT
• Living Hope; LLC
• Shanna Longino

• All providers in Prentiss, MS
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.