Individual provider Active NPI

Jagjit Singh Tandon, MD

  • Hematology & Oncology Physician
  • Lynn Haven, FL
National Provider Identifier
1669599296
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
C172028 Issued in CA
Practice address
2900 S Highway 77
Lynn Haven, FL 32444
Phone
(850) 481-1687
Fax
(850) 640-0761
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME141233 FL
Hematology & Oncology Physician 207RH0003X MD038233L PA
Hematology & Oncology Physician 207RH0003X C172028 CA Primary

Addresses

Primary practice location

2900 S Highway 77
Lynn Haven, FL 32444

Mailing address

480 4TH Ave Ste 409
Chula Vista, CA 91910-4413
Phone (619) 425-2080

Other identifiers 1

IdentifierTypeStateIssuer
0015360790001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20211201000491 CA Practitioner - Hematology/Oncology 6406951144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Tumor Medical Group a Medical CorporationGroup PAC ID 8820045966, 4 clinicians

Practice addresses (Care Compare)

38660 Medical Ctr Dr
Palmdale, CA 93551-4385
Phone (661) 208-4790

607 W Ave Q
Suite a
Palmdale, CA 93551-3872
Phone (661) 948-5928

Hospital & facility affiliations

  • Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056
  • Ridgecrest Regional Hospital Hospital, Ridgecrest, CA, CCN 051333
  • Palmdale Regional Medical Center Hospital, Palmdale, CA, CCN 050204

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C172028CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olean General Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jagjit.tandon@avcc.direct-geniusdoc.com

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 4

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1669599296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 4TH AVE STE 409",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104413",
            "telephone_number": "619-425-2080",
            "fax_number": "619-425-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S HIGHWAY 77",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "32444",
            "telephone_number": "850-481-1687",
            "fax_number": "850-640-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDON",
        "first_name": "JAGJIT",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME141233",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MD038233L",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "C172028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015360790001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn Haven, FL

Sources for this page

Verify at the official NPI Registry.