Individual provider Active NPI

Benjamin P Jagiello, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Cranberry TWP, PA
National Provider Identifier
1659334332
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD038951E Issued in PA
Practice address
One Landmark North 20399 Route 19
Suite 203
Cranberry TWP, PA 16066
Phone
(724) 772-8000
Fax
(724) 772-8040
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD038951E PA Primary

Addresses

Primary practice location

One Landmark North 20399 Route 19
Suite 203
Cranberry TWP, PA 16066

Mailing address

1605 Lakes Pkwy
Lawrenceville, GA 30043-5858
Phone (904) 819-4478

Other identifiers 1

IdentifierTypeStateIssuer
0016475970005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20051219000699 PA Practitioner - Internal Medicine 8224050232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9400 McKnight Rd
Suite 103
Pittsburgh, PA 15237-6007

Hospital & facility affiliations

  • Upmc Passavant Hospital, Pittsburgh, PA, CCN 390107

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Plus Geriatric Medicine CurrentSince Sep 8, 1997 Accepting new patients
Upmc Passavant Past Accepting new patients

Locations

601 Monroe Ave
Pittsburgh, PA 15202
Phone (412) 734-3030

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 2

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1659334332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 LAKES PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435858",
            "telephone_number": "904-819-4478",
            "fax_number": "904-819-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE LANDMARK NORTH 20399 ROUTE 19",
            "address_2": "SUITE 203",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "16066",
            "telephone_number": "724-772-8000",
            "fax_number": "724-772-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGIELLO",
        "first_name": "BENJAMIN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD038951E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016475970005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry TWP, PA

Sources for this page

Verify at the official NPI Registry.