Raja Kishinchand Jagtiani, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA063561 Issued in NJ

Practice address

297 S Washington Ave
Suite # 1
Bergenfield, NJ 07621-3789

Phone

(201) 387-0087

Fax

(201) 387-2232

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Premier Medical Alliance LLC

  • Gastroenterology Physician
  • Emerson, NJ
  • NPI 1093142895
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659320281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 S WASHINGTON AVE",
            "address_2": "SUITE # 1",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213789",
            "telephone_number": "201-387-0087",
            "fax_number": "201-387-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 S WASHINGTON AVE",
            "address_2": "SUITE # 1",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213789",
            "telephone_number": "201-387-0087",
            "fax_number": "201-387-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGTIANI",
        "first_name": "RAJA",
        "middle_name": "KISHINCHAND",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA063561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7867000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J & K Ambulance LLC
• J&C Picache - Igwt
• Tamar Jacob
• Terence Jacob, DPT
• Jagtiani Urgent& Primary Care, LLC
• Shoa Javaid
• Maryam Javdan, PHARM D
• Kristen Jayson, DPT
• Robin Jefferson
• Jersey Family Foot and Ankle LLC

• Internal Medicine Physician in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.