NPIMap

Individual provider Active NPI

Maya Jagasia, MD

  • Emergency Medicine Physician
  • Normal, IL
National Provider Identifier
1821045089
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
36053763 Issued in IL
Practice address
1909 Quail Run CC CT
Normal, IL 61761-5210
Phone
(309) 451-3699
Fax
(904) 805-1302
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 36053763 IL Primary

Addresses

Primary practice location

1909 Quail Run CC CT
Normal, IL 61761-5210

Mailing address

1909 Quail Run CC CT
Normal, IL 61761-5210
Phone (309) 451-3699

Other identifiers 2

IdentifierTypeStateIssuer
0360537633MedicaidIL
P00195135OtherRAILROAD MCR

Other names 1

  • Maya F Pardasani Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36053763ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Illinois Neuroradiology, LTD Past Accepting new patients
Prairie Emergency Group, LTD. Past Accepting new patients
Princeton Emergency Services, LLC Emergency Medicine Past Accepting new patients
Bestpractices of Illinois PC Emergency Medicine Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1821045089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 QUAIL RUN CC CT",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615210",
            "telephone_number": "309-451-3699",
            "fax_number": "904-805-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 QUAIL RUN CC CT",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615210",
            "telephone_number": "309-451-3699",
            "fax_number": "904-805-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGASIA",
        "first_name": "MAYA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "36053763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360537633",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P00195135",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYA",
            "last_name": "PARDASANI",
            "middle_name": "F",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.