Individual provider Active NPI

Tejaswini Jagadish, M.D.

  • Internal Medicine Physician
  • Sylvania, OH
National Provider Identifier
1720423627
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35128133 Issued in OH
Practice address
5200 Harroun Rd
Sylvania, OH 43560-2168
Phone
(419) 824-5540
Fax
(419) 882-7028
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 35128133 OH Primary

Addresses

Primary practice location

5200 Harroun Rd
Sylvania, OH 43560-2168

Mailing address

1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (419) 824-5540

Other identifiers 1

IdentifierTypeStateIssuer
0170493MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tjagadish47304@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160725001077 OH Practitioner - Internal Medicine 7911290200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-1111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35128133OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Toledo Hospital Past Accepting new patients

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 2

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": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1720423627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "419-824-5540",
            "fax_number": "419-824-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARROUN RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602168",
            "telephone_number": "419-824-5540",
            "fax_number": "419-882-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGADISH",
        "first_name": "TEJASWINI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2023-11-03",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35128133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170493",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjagadish47304@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.