Individual provider Active NPI

Jagadish C Malakar, M.D.

  • Internal Medicine Physician
  • Cortland, NY
National Provider Identifier
1700879640
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
247103-1 Issued in NY
Practice address
129 Homer Ave
Cortland, NY 13045-1230
Phone
(607) 753-3355
Fax
(607) 753-8724
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 247103-1 NY Primary

Addresses

Primary practice location

129 Homer Ave
Cortland, NY 13045-1230

Mailing address

129 Homer Ave
Cortland, NY 13045-1230
Phone (607) 753-3355

Other identifiers 2

IdentifierTypeStateIssuer
247103-1OtherNYLICENSE #
01950467MedicaidNY

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
I20080528000537 NY Practitioner - Internal Medicine 8527029776 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)

129 Homer Ave
Cortland, NY 13045-1209
Phone (607) 753-3355

129 Homer Ave
Cortland, NY 13045-1230

134 Homer Ave
Cortland, NY 13045-1206
Phone (607) 753-3355

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247103-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cortland Medical Care, PC Internal Medicine CurrentSince Mar 11, 2002 Accepting new patients
Guthrie Cortland Medical Center Past Accepting new patients

Locations

129 Homer Ave
Ste 1
Cortland, NY 13045

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 9

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1700879640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 HOMER AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451230",
            "telephone_number": "607-753-3355",
            "fax_number": "607-753-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 HOMER AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451230",
            "telephone_number": "607-753-3355",
            "fax_number": "607-753-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAKAR",
        "first_name": "JAGADISH",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "247103-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "247103-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01950467",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

Verify at the official NPI Registry.