NPIMap

Organization Active NPI

Jag Geriatrics PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Longmeadow, MA
National Provider Identifier
1467883124
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
210498 Issued in MA
Legal business name
JAG GERIATRICS PC
Practice address
770 Converse St
Longmeadow, MA 01106-1719
Phone
(413) 567-6213
NPI assigned
Dec 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Authorized official

Name
Udaya B Jagadeesan, M.D.
Title
Owner
Phone
(413) 426-3862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X 210498 MA Primary

Addresses

Primary practice location

770 Converse St
Longmeadow, MA 01106-1719

Mailing address

PO Box 60907
Longmeadow, MA 01116-5907

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1467883124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60907",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011165907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 CONVERSE ST",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011061719",
            "telephone_number": "413-567-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAG GERIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "JAGADEESAN",
        "authorized_official_first_name": "UDAYA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-426-3862",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "210498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmeadow, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.