Individual provider Active NPI

Jatinder Bhardwaj, MD

  • Pediatric Gastroenterology Physician
  • Phoenix, AZ
National Provider Identifier
1689736043
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
80583 Issued in AZ
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 344-5011
NPI assigned
Dec 14, 2006
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 80583 AZ
Pediatrics Physician 208000000X 300245 LA
Pediatrics Physician 208000000X C161299 CA
Pediatrics Physician 208000000X IN PROCESS NY
Pediatric Gastroenterology Physician 2080P0206X 300245 LA
Pediatric Gastroenterology Physician 2080P0206X C161299 CA
Pediatric Gastroenterology Physician 2080P0206X 80583 AZ Primary
Pediatric Gastroenterology Physician 2080P0206X 35097380 OH

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (318) 626-0287

Other practice location 1

101 Guilbeau Rd
Lafayette, LA 70506-6138
Phone (337) 889-3817

Other practice location 2

1100 Van Ness Ave Fl 7
San Francisco, CA 94109-6978
Phone (415) 600-4050

Other practice location 3

1100 Van Ness Ave Fl 7
San Francisco, CA 94109-6978
Phone (415) 600-4050

Other practice location 4

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0000

Other identifiers 5

IdentifierTypeStateIssuer
0054928MedicaidOH
75264OtherOHMERIDAN
9353771OtherOHAETNA
000000733570OtherOHANTHEM
2433369MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20191018000566 LA Practitioner - Pediatric Medicine 3577639459 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80583AZMDPediatrics Physician
C161299CAMDPediatric Gastroenterology Physician
300245LAMDPediatric Gastroenterology Physician
35097380OHMDPediatric Gastroenterology Physician
IN PROCESSNYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Pediatrics CurrentSince Sep 1, 2019 Accepting new patients
Acadiana Pediatric Gastroenterology and Hepatology Pediatric Gastroenterology CurrentSince Feb 2, 2020 Accepting new patients
Promedica Children's Specialists Pediatrics PastSince Jan 1, 2017 Accepting new patients

Locations

4630 Ambassador Caffery Pkwy
Ste 406
Lafayette, LA 70508
Phone (337) 989-8770

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12923/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1689736043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "318-626-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Guilbeau Rd",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705066138",
            "country_code": "US",
            "telephone_number": "337-889-3817",
            "fax_number": "337-889-3818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Van Ness Ave Fl 7",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941096978",
            "country_code": "US",
            "telephone_number": "415-600-4050",
            "fax_number": "415-600-4003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Van Ness Ave Fl 7",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941096978",
            "country_code": "US",
            "telephone_number": "415-600-4050",
            "fax_number": "415-600-4003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1541 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-626-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHARDWAJ",
        "first_name": "JATINDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "80583",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "300245",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C161299",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "IN PROCESS",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "LA",
            "license": "300245",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "C161299",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AZ",
            "license": "80583",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OH",
            "license": "35097380",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054928",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERIDAN",
            "identifier": "75264",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9353771",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000733570",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2433369",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.