NPIMap

Individual provider Active NPI

Kanagaratnam Jegathesan, MD

  • Internal Medicine Physician
  • Waterbury, CT
National Provider Identifier
1497859409
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17004 Issued in CT
Practice address
2271 East Main Street
Waterbury, CT 06705
Phone
(203) 753-4131
Fax
(203) 753-6887
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 17004 CT Primary
Pulmonary Disease Physician 207RP1001X 170040 CT

Addresses

Primary practice location

2271 East Main Street
Waterbury, CT 06705

Mailing address

2271 East Main Street
Waterbury, CT 06705
Phone (203) 753-4131

Other identifiers 3

IdentifierTypeStateIssuer
0R1848OtherCTHEALTH NET
001170042MedicaidCT
010017004CT01OtherCTBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20031113000713 CT Practitioner - Internal MedicinePractitioner - Pulmonary Disease 0244144392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1962
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Health of New England Provider Network Organization IncGroup PAC ID 0941113567, 644 clinicians

Practice addresses (Care Compare)

3801 E Main St
FL 2
Waterbury, CT 06705-3815
Phone (203) 709-4001

Hospital & facility affiliations

  • Trinity Health of New England at Home Home health agency, Hartford, CT, CCN 077005
  • Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
  • Uconn Health Community Network Home Health, Inc. Home health agency, Watertown, CT, CCN 077085
  • Accentcare Hospice & Palliative Care of Conecticut Hospice, Middlebury, CT, CCN 071539
  • Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Apple Rehab Watertown Nursing home, Watertown, CT, CCN 075181
  • Complete Care at Glendale Nursing home, Naugatuck, CT, CCN 075240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170040CTMDPulmonary Disease Physician
17004CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

166 Waterbury Rd
Ste 300
Prospect, CT 06712
Phone (203) 709-5300

Interoperability endpoints

  • Direct secure messaging: kjegathesan2997003@direct.trinity-health.org

Organizations & group practices 2

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 10

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1497859409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 EAST MAIN STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06705",
            "telephone_number": "203-753-4131",
            "fax_number": "203-753-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2271 EAST MAIN STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06705",
            "telephone_number": "203-753-4131",
            "fax_number": "203-753-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEGATHESAN",
        "first_name": "KANAGARATNAM",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "17004",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "170040",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0R1848",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001170042",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010017004CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.