Individual provider Active NPI

Anitesh Jaswal, M.D.

  • Family Medicine Physician
  • Titusville, FL
National Provider Identifier
1639753049
Registry record updated Sep 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME166386 Issued in FL
Practice address
494 N Washington Ave
Titusville, FL 32796-2871
Phone
(321) 267-8311
NPI assigned
May 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD483220 PA
Family Medicine Physician 207Q00000X MT224038 PA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME166386 FL Primary

Addresses

Primary practice location

494 N Washington Ave
Titusville, FL 32796-2871

Mailing address

494 N Washington Ave
Titusville, FL 32796-2871
Phone (321) 267-8311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240709002316 FL Practitioner - Family Practice 3971901653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Brevard Medical Support IncGroup PAC ID 7618870296, 62 clinicians

Practice addresses (Care Compare)

250 Harrison St
Titusville, FL 32780-5094
Phone (321) 268-6834

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
75.26
Promoting interoperability
100
Improvement activities
40
Cost
78.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME166386FLMDFamily Medicine Physician
MD483220PAMDFamily Medicine Physician
MT224038PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Brevard Medical Support, Inc CurrentSince Aug 2, 2024 Accepting new patients
The Wright Center Medical Group Family Medicine PastSince Feb 24, 2022 Accepting new patients
The Wright Center Medical Group Family Medicine PastSince Oct 1, 2021 Accepting new patients

Locations

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

494 N Washington Ave
Titusville, FL 32796
Phone (321) 267-8311

250 Harrison St
Titusville, FL 32780
Phone (321) 268-6868

Interoperability endpoints

  • Direct secure messaging: anitesh.jaswal.1@17832.direct.athenahealth.com

Organizations & group practices 3

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": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727568000000",
    "number": "1639753049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "494 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962871",
            "telephone_number": "321-267-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "494 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962871",
            "telephone_number": "321-267-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASWAL",
        "first_name": "ANITESH",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-11",
        "last_updated": "2024-09-29",
        "certification_date": "2024-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD483220",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT224038",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME166386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.