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GOWTHAMI SAI KOGILATHOTA JAGIRDHAR
NPI 1053940379
Internal Medicine - Gastroenterology in Newark, NJ

Active since April 07, 2020PECOS Enrolled
111 CENTRAL AVE, NEWARK, NJ 07102(973) 877-5000 Get Directions Write a Review

NPPES record last updated: May 23, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 23, 2026, Apr 7, 2020 (2 updates tracked since 2020).

About Gowthami Sai Kogilathota Jagirdhar NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOWTHAMI SAI KOGILATHOTA JAGIRDHAR (NPI 1053940379) is an individual gastroenterology provider in Newark, New Jersey, licensed in Delaware (C1-0029484) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053940379
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameGOWTHAMI SAI KOGILATHOTA JAGIRDHAR
Location Address111 CENTRAL AVENewark, NJ 07102-1909
Mailing Address111 Central AveNewark, NJ 07102-1909 · (973) 877-5000
Phone(973) 877-5000
Sole ProprietorNo
Enumeration DateApril 7, 2020
Last NPPES UpdateMay 23, 20262 updates tracked since enumeration
NPPES CertifiedMay 23, 2026
✔ NPI 1053940379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in DE · C1-0029484
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
111 CENTRAL AVE, Newark, NJ 07102
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gowthami Sai Kogilathota Jagirdhar is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAKAN BASSAM AMMARI MD
Student in an Organized Health Care Education/Training Program
111 CENTRAL AVE
NEWARK, NJ 07102
Essex County (973) 877-5000
PAUL V SCOTT CRNA
Registered Nurse
111 CENTRAL AVE
NEWARK, NJ 07102
Essex County (973) 877-5043
DR. HOI-WING SUSANNA YIM M.D.
Internal Medicine
111 CENTRAL AVE
NEWARK, NJ 07102
Essex County (973) 877-5000
KING EMERGENCY ASSOCIATES, P.A.
Emergency Medicine
111 CENTRAL AVE
NEWARK, NJ 07102
Essex County (973) 877-5000
DR. NITA MODI MD
Specialist
111 CENTRAL AVE
NEWARK, NJ 07102
Essex County (973) 877-5000
GATEWAY EMERGENCY SERVICES PC
Emergency Medicine
111 CENTRAL AVE, EMERGENCY DEPARTMENT
NEWARK, NJ 07102
Essex County (469) 401-2386
DR. CHRYSTINA MILDRED KIWAN MD
Student in an Organized Health Care Education/Training Program
111 CENTRAL AVE
NEWARK, NJ 07102
Essex County (973) 877-5000
KHALED MOHAMMAD KHALED BANI YASEEN MD
Student in an Organized Health Care Education/Training Program
111 CENTRAL AVE
NEWARK, NJ 07102
Essex County (551) 250-3743

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gowthami Sai Kogilathota Jagirdhar's NPI number?

The NPI number for Gowthami Sai Kogilathota Jagirdhar is 1053940379. It was assigned to this individual provider in the NPPES registry on April 7, 2020.

Where is Gowthami Sai Kogilathota Jagirdhar located?

Gowthami Sai Kogilathota Jagirdhar practices at 111 Central Ave, Newark, NJ 07102. The listed phone number is (973) 877-5000.

What is Gowthami Sai Kogilathota Jagirdhar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Gowthami Sai Kogilathota Jagirdhar enrolled in Medicare?

Yes. Gowthami Sai Kogilathota Jagirdhar is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gowthami Sai Kogilathota Jagirdhar was last updated on May 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.