Individual provider Active NPI

Israt Jahan, MD, PHD

  • Psychiatry Physician
  • Tampa, FL
National Provider Identifier
1720010267
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME94116 Issued in FL
Practice address
James a. Haley Veterans Hospital
13000 Bruce B. Downs Blvd. (116a)
Tampa, FL 33612
Phone
(813) 631-7124
Fax
(813) 631-7128
NPI assigned
Jul 7, 2006
Last updated
Mar 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME94116 FL Primary

Addresses

Primary practice location

James a. Haley Veterans Hospital
13000 Bruce B. Downs Blvd. (116a)
Tampa, FL 33612

Mailing address

3126 Highlands Lakeview Cir
Lakeland, FL 33813
Phone (863) 619-9853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250207003407 FL Practitioner - Neuropsychiatry 9537194451 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Diseases Care for All LLC CurrentSince Dec 27, 2024 Accepting new patients
MCV Associated Physicians Psychiatry PastSince Sep 28, 2021 Accepting new patients

Locations

3830 S Florida Ave
Lakeland, FL 33813
Phone (863) 519-0902

508 E Garden St
Lakeland, FL 33805
Phone (813) 688-2447

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, 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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1720010267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 HIGHLANDS LAKEVIEW CIR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33813",
            "telephone_number": "863-619-9853",
            "fax_number": "813-631-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JAMES A. HALEY VETERANS HOSPITAL",
            "address_2": "13000 BRUCE B. DOWNS BLVD. (116A)",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-631-7124",
            "fax_number": "813-631-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHAN",
        "first_name": "ISRAT",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME94116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.