Individual provider Active NPI

Jagroop Singh Khaira

  • Internal Medicine Physician
  • Cheverly, MD
National Provider Identifier
1336554591
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60712876 Issued in WA
Practice address
3001 Hospital Drive, 5TH Floor
Prince George'S Hospital Center(Department of Medicine)
Cheverly, MD 20785
Phone
(301) 618-3776
Fax
(301) 618-2986
NPI assigned
Jun 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60712876 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3001 Hospital Drive, 5TH Floor
Prince George'S Hospital Center(Department of Medicine)
Cheverly, MD 20785

Mailing address

3001 Hospital Drive, 5TH Floor
Prince George'S Hospital Center(Department of Medicine)
Cheverly, MD 20785
Phone (301) 618-3776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20170627001809 WA Practitioner - HospitalistPractitioner - Internal Medicine 0648549196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2901 Sqaulicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 734-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60712876WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince May 13, 2017 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince May 13, 2017 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
Peacehealth Past Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Organizations & group practices 4

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 3

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": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1336554591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DRIVE, 5TH FLOOR",
            "address_2": "PRINCE GEORGE'S HOSPITAL CENTER(DEPARTMENT OF MEDICINE)",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "20785",
            "telephone_number": "301-618-3776",
            "fax_number": "301-618-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DRIVE, 5TH FLOOR",
            "address_2": "PRINCE GEORGE'S HOSPITAL CENTER(DEPARTMENT OF MEDICINE)",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "20785",
            "telephone_number": "301-618-3776",
            "fax_number": "301-618-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRA",
        "first_name": "JAGROOP",
        "middle_name": "SINGH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-26",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60712876",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheverly, MD

Sources for this page

Verify at the official NPI Registry.