Individual provider Active NPI

Jasdeep S Mangat, M.D.

  • Internal Medicine Physician
  • East Elmhurst, NY
National Provider Identifier
1649683293
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
289274 Issued in NY
Practice address
1818 Hazen St
East Elmhurst, NY 11370
Phone
(347) 578-2259
NPI assigned
Jun 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 289274 NY Primary

Addresses

Primary practice location

1818 Hazen St
East Elmhurst, NY 11370

Mailing address

55 Water St FL 18
New York, NY 10041-0004
Phone (347) 578-2259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230412000345 NY Practitioner - Internal Medicine 1759756471 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
289274NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Apr 1, 2023 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Current Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Locations

450 Clarkson Ave
#59
Brooklyn, NY 11203
Phone (718) 270-2078

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 421-1003

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: jmangat662108@nychhc.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1649683293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 18",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "347-578-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 HAZEN ST",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "11370",
            "telephone_number": "347-578-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAT",
        "first_name": "JASDEEP",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "289274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.