NPIMap

Individual provider Active NPI

Madhu C Jagadish, P.A.C.

  • Physician Assistant
  • Bloomfield Hills, MI
National Provider Identifier
1679585343
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002987 Issued in MI
Practice address
3893 Glen Falls Dr
Bloomfield Hills, MI 48302-1226
Phone
(248) 943-1644
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002987 MI Primary

Addresses

Primary practice location

3893 Glen Falls Dr
Bloomfield Hills, MI 48302-1226

Mailing address

3893 Glen Falls Dr
Bloomfield Hills, MI 48302-1226
Phone (248) 943-1644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050831000751 MI Practitioner - Physician Assistant 5698677664 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ben-Ami Psychiatry and Psychotherapy PastSince Jan 1, 2013 Accepting new patients
Continuum Psychiatric Services, LLP Past Accepting new patients
Geriatric Psychiatric Services PLLC Past Accepting new patients
Geriatric Psychiatric Services PLLC Past Accepting new patients
David Gurevitch MD PC Past Accepting new patients
Seniors Wellness Group of Michigan, P.C. Past Accepting new patients
Geriatric Psychiatric Services PLLC Past Accepting new patients
Geriatric Psychiatric Services PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: madhu.jagadish.1@23821.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679585343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3893 GLEN FALLS DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021226",
            "telephone_number": "248-943-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3893 GLEN FALLS DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021226",
            "telephone_number": "248-943-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGADISH",
        "first_name": "MADHU",
        "middle_name": "C",
        "credential": "P.A.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.