NPIMap

Individual provider Active NPI

Jagdish Mirchandani, M.D.

  • Nephrology Physician
  • Flint, MI
National Provider Identifier
1710940853
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301062608 Issued in MI
Practice address
5080 Villa Linde Pkwy
Suite 2
Flint, MI 48532-3411
Phone
(810) 720-0162
Fax
(810) 720-0301
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 4301062608 MI Primary

Addresses

Primary practice location

5080 Villa Linde Pkwy
Suite 2
Flint, MI 48532-3411

Mailing address

1711 Momentum PL
Lockbox Number 231711
Chicago, IL 60689-5317
Phone (810) 732-5482

Other identifiers 1

IdentifierTypeStateIssuer
4496119MedicaidMI

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
I20051010000175 MI Practitioner - Nephrology 6305819269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mid Michigan Kidney and Hypertension Specialists, P.C.Group PAC ID 1153394010, 3 clinicians

Practice addresses (Care Compare)

5080 Villa Linde Pkwy
Suite 2
Flint, MI 48532-3423
Phone (810) 720-0162

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
83.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Michigan Kidney and Hypertension Specialists, P.C. Nephrology CurrentSince Jun 1, 2003 Accepting new patients
Reliant Renal Care - Davison, LLC PastSince Oct 18, 2017 Accepting new patients
Premier Medical Clinics PC PastSince Jun 1, 2003 Accepting new patients
Mid Michigan Home Health and Hospice LLC PastSince Mar 10, 2011 Accepting new patients
Renal Nutrition Consultants Inc. Past Accepting new patients

Locations

1711 Momentum Pl
Chicago, IL 60689

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

5080 Villa Linde Pkwy
Flint, MI 48532
Phone (810) 720-0162

5080 Villa Linde Pkwy
Ste 2
Flint, MI 48532
Phone (810) 720-0162

4200 Beecher Rd
Flint, MI 48532
Phone (810) 342-4964

1254 N Main St
Lapeer, MI 48446
Phone (810) 664-4531

Interoperability endpoints

  • Direct secure messaging: jmirchandani1141745@direct.hfhs.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mid Michigan Home Health and Hospice LLCFlint, MI, CCN 231640 Hospice Corporate Director (100%) Mar 10, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 12

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1710940853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 MOMENTUM PL",
            "address_2": "LOCKBOX NUMBER 231711",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895317",
            "telephone_number": "810-732-5482",
            "fax_number": "810-720-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 VILLA LINDE PKWY",
            "address_2": "SUITE 2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323411",
            "telephone_number": "810-720-0162",
            "fax_number": "810-720-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRCHANDANI",
        "first_name": "JAGDISH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301062608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4496119",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.