Individual provider Active NPI

Jalaj Garg, M.D

  • Clinical Cardiac Electrophysiology Physician
  • Loma Linda, CA
National Provider Identifier
1558631663
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
A171961 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4000
NPI assigned
Jan 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 71429 WI
Clinical Cardiac Electrophysiology Physician 207RC0001X 71429 WI
Clinical Cardiac Electrophysiology Physician 207RC0001X A171961 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 955-6777

Other practice location 1

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 955-6777

Other practice location 2

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7200

Other practice location 3

7901 S 6th St
Oak Creek, WI 53154-2010
Phone (414) 346-8000

Other identifiers 1

IdentifierTypeStateIssuer
1558631663MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190729003087 WI Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 8527343433 Reassigns benefits to 2 organizations
I20210607001321 CA Practitioner - Cardiac Electrophysiology 8527343433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174

81 Highland Springs Ave
Beaumont, CA 92223-3170
Phone (909) 558-4000

901 San Bernardino Rd
Suite 104And302
Upland, CA 91786-4912
Phone (909) 558-4000

File Number
Suite 54701
Los Angeles, CA 90074-4701

Hospital & facility affiliations

  • Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A171961CAMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 22, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2021 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 22, 2019 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm Cardiovascular Disease Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

11234 Anderson St
Fl 6
Loma Linda, CA 92350

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
Fl 7
Loma Linda, CA 92350

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

4805 S Moorland Rd
New Berlin, WI 53151
Phone (262) 798-7200

7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jgarg375201@direct.llu.edu

Organizations & group practices 7

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 1

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": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1558631663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-955-6777",
            "fax_number": "414-955-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-955-6777",
            "fax_number": "414-955-6203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4805 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517401",
            "country_code": "US",
            "telephone_number": "262-798-7200",
            "fax_number": "262-798-7271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531542010",
            "country_code": "US",
            "telephone_number": "414-346-8000",
            "fax_number": "414-346-8010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARG",
        "first_name": "JALAJ",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-05",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "71429",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WI",
            "license": "71429",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A171961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558631663",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.