Individual provider Active NPI

Kamini Krishnaswamy Jagdish, MD

  • Internal Medicine Physician
  • Lancaster, PA
National Provider Identifier
1891758504
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD449474 Issued in PA
Practice address
250 College Ave
Lancaster, PA 17603-3363
Phone
(717) 231-8772
Fax
(717) 231-8435
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 215334 NY
Internal Medicine Physician 207R00000X MD449474 PA Primary

Addresses

Primary practice location

250 College Ave
Lancaster, PA 17603-3363

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612
Phone (717) 231-8698

Other identifiers 3

IdentifierTypeStateIssuer
P00391113OtherNYMEDICARE RAILROAD
WORKER'S COMPENSATIOOtherNY215334-W CIM
02283329MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20131023000202 PA Practitioner - HospitalistPractitioner - Internal Medicine 8729080254 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Hospitalist Services LLC Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Pinnacle Health Regional Physicians CurrentSince Oct 1, 2017 Accepting new patients
Pinnacle Health Regional Physicians Internal Medicine CurrentSince Oct 1, 2017 Accepting new patients
Internal Medicine at Lakeside Internal Medicine Past Accepting new patients
Rochester Vascular Medicine, PC Past Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

366 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-1900

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

250 College Ave
Lancaster, PA 17603
Phone (717) 291-8211

250 College Ave
Fl 5
Lancaster, PA 17603
Phone (717) 291-8512

1500 Highlands Dr
Lititz, PA 17543
Phone (717) 625-5000

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891758504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "telephone_number": "717-231-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 COLLEGE AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033363",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGDISH",
        "first_name": "KAMINI",
        "middle_name": "KRISHNASWAMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "215334",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD449474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00391113",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "215334-W CIM",
            "identifier": "WORKER'S COMPENSATIO",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02283329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.