NPIMap

Individual provider Active NPI

Ujjwal Dhar, M.D.

  • Infectious Disease Physician
  • Jackson, MS
National Provider Identifier
1841223377
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
37134 Issued in TN
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(601) 200-4714
Fax
(601) 200-4718
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37134 TN
Infectious Disease Physician 207RI0200X 37134 TN Primary
Infectious Disease Physician 207RI0200X 20776 MS

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4749

Other identifiers 5

IdentifierTypeStateIssuer
03900372MedicaidMS
29136OtherTNTLC
3328251MedicaidTN
4099087OtherTNBLUE CROSS BLUE SHIELD
P01059006OtherMSRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20091110000476 MS Practitioner - Infectious DiseasePractitioner - Internal Medicine 9234121633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

106 Highland Way
Madison, MS 39110-6933

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-3100

Hospital & facility affiliations

  • Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
  • Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
  • Accentcare Home Health of Greenwood Home health agency, Greenwood, MS, CCN 257131
  • Accentcare Home Health of Carthage Home health agency, Carthage, MS, CCN 257129
  • Centerwell Home Health Home health agency, Flowood, MS, CCN 257126
  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
  • Baptist Medical Center-Leake Hospital, Carthage, MS, CCN 251315
  • Merit Health River Region Hospital, Vicksburg, MS, CCN 250031
  • King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37134TNMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Dominic Medical Associates LLC CurrentSince Oct 1, 2011 Accepting new patients
St Dominic Medical Associates LLC CurrentSince Oct 1, 2011 Accepting new patients
St. Dominic Medical Associates LLC Current Accepting new patients
Baptist Memorial Medical Group Inc Past Accepting new patients
Baptist Memorial Medical Group Inc Internal Medicine Past Accepting new patients

Locations

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376

Interoperability endpoints

  • Direct secure messaging: udhar2548937@direct.casso.us.com

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 10

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1841223377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-4714",
            "fax_number": "601-200-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHAR",
        "first_name": "UJJWAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "37134",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TN",
            "license": "37134",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MS",
            "license": "20776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03900372",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "29136",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3328251",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4099087",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01059006",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.