Individual provider Active NPI

Jaswant Singh Bagga, MD

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Pontiac, MI
National Provider Identifier
1740349620
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
4301036917 Issued in MI
Practice address
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Phone
(248) 858-7766
Fax
(248) 858-7201
NPI assigned
Dec 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 4301036917 MI Primary

Addresses

Primary practice location

114 Orchard Lake Rd
Pontiac, MI 48341-2244

Mailing address

114 Orchard Lake Rd
Pontiac, MI 48341-2244
Phone (248) 858-7766

Other identifiers 1

IdentifierTypeStateIssuer
1883825MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100519000662 MI Practitioner - PsychiatryPractitioner - Addiction MedicinePractitioner - Geriatric Psychiatry 7810026408 Reassigns benefits to 4 organizations
Practice locations: Auburn Hills, MI

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Havenwyck Hospital Inc CurrentSince Mar 11, 2018 Accepting new patients
Havenwyck Hospital Inc CurrentSince Mar 11, 2018 Accepting new patients
Lincoln Behavioral Services CurrentSince Jan 18, 2022 Accepting new patients
Lincoln Behavioral Services CurrentSince Jan 18, 2022 Accepting new patients
Recovery Physicians Network of Michigan CurrentSince Aug 1, 2021 Accepting new patients
Downriver Mental Health Clinic PC Past Accepting new patients

Locations

1525 University Dr
Auburn Hills, MI 48326
Phone (248) 371-2200

9315 Telegraph Rd
Redford, MI 48239
Phone (313) 937-9500

101 W Townsend Rd
Saint Johns, MI 48879
Phone (989) 403-6022

Organizations & group practices 7

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": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740349620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGGA",
        "first_name": "JASWANT",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MI",
            "license": "4301036917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.