Individual provider Active NPI

Andy Jagoda, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1669449690
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2006931 Issued in NY
Practice address
100TH Street and Madison Ave
New York, NY 10029
Phone
(212) 241-0101
Fax
(212) 426-5083
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2006931 NY Primary

Addresses

Primary practice location

100TH Street and Madison Ave
New York, NY 10029

Mailing address

170 East 87TH St
Ste W20C
New York, NY 10128
Phone (212) 241-0101

Other identifiers 2

IdentifierTypeStateIssuer
01390752MedicaidNY
930061988OtherNYRR MEDICARE

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
I20070301000184 NY Practitioner - Emergency Medicine 7315049848 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Georgetown University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1468 Madison Ave
New York, NY 10029-6508
Phone (212) 987-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006931NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Nov 25, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Mar 1, 2014 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Fpa Hospital Based CurrentSince May 1, 2013 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince May 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai School of Medicine Emergency Medicine Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1440 Madison Ave
New York, NY 10029
Phone (212) 241-5561

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

234 E 85th St
New York, NY 10028
Phone (212) 241-6585

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

Networks

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

Organizations & group practices 10

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 6

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1669449690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 EAST 87TH ST",
            "address_2": "STE W20C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10128",
            "telephone_number": "212-241-0101",
            "fax_number": "212-426-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100TH STREET AND MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-0101",
            "fax_number": "212-426-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGODA",
        "first_name": "ANDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "2006931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01390752",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "930061988",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.