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JAGA MEDICAL GROUP INC
NPI 1356898357
General Practice in Eagle Rock, CA

Active since September 07, 2016
1400 COLORADO BLVD, A, EAGLE ROCK, CA 90041(323) 999-2250(323) 999-2241 Get Directions Write a Review

NPPES record last updated: October 20, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jaga Medical Group Inc NPPES

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

JAGA MEDICAL GROUP INC (NPI 1356898357) is a healthcare organization registered as a general practice in Eagle Rock, California and active in the NPI registry since September 2016. The organization lists Ardienne Ann Grant, President, as its authorized official.

NPPES Registry Identity

NPI1356898357
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameJAGA MEDICAL GROUP INC
Location Address1400 COLORADO BLVD, AEagle Rock, CA 90041-2321
Mailing Address1400 Colorado Blvd, AEagle Rock, CA 90041-2321 · (323) 999-2250 · Fax (323) 999-2241
Phone(323) 999-2250
Fax(323) 999-2241
Organization SubpartNo
Authorized OfficialArdienne Ann GrantPresident · (323) 999-2250
Enumeration DateSeptember 7, 2016
Last NPPES UpdateOctober 20, 2016
✔ NPI 1356898357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · 20A7285
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1400 COLORADO BLVD, Eagle Rock, CA 90041
Open in Google Maps ↗

Other Identifiers 1

Medicare OSCAR/certification20A7285CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaga Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Jaga Medical Group Inc, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Meri Petrosyan, FNP-C
Nurse Practitioner
NPI 1306513270
401 N BRAND BLVD STE 726
Glendale, CA 91203
(818) 239-9293
✔ PECOS✔ Accepts Medicare3.6 mi
Adrienne Grant, D.O.
General Practice
NPI 1063571834
1777 N BELLFLOWER BLVD STE 107
Long Beach, CA 90815
(562) 597-6020
✔ PECOS✔ Accepts Medicare25 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Jaga Medical Group Inc's NPI number?

The NPI number for Jaga Medical Group Inc is 1356898357. It was assigned to this organization in the NPPES registry on September 7, 2016.

Where is Jaga Medical Group Inc located?

Jaga Medical Group Inc is located at 1400 Colorado Blvd A, Eagle Rock, CA 90041. The listed phone number is (323) 999-2250.

What is Jaga Medical Group Inc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Jaga Medical Group Inc enrolled in Medicare?

Yes. Jaga Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jaga Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Jaga Medical Group Inc, in General Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jaga Medical Group Inc was last updated on October 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.