Provider Demographics
NPI:1174500730
Name:BHAGIA, JYOTI (MD)
Entity Type:Individual
Prefix:
First Name:JYOTI
Middle Name:
Last Name:BHAGIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN402302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01F29BHMedicaid
MNA025OtherCHAMPUS
MN121582Medicaid
MN839393OtherARAZ
MN23126OtherSIOUX VALLEY
MN7295OtherAVERA
MN829018100Medicaid
MNMH9041015905OtherPREFERREDONE
MN01F29BHOtherBLUE CROSS
MNHP30075OtherHEALTHPARTNERS
IA516393Medicaid
MN260037684OtherRAILROAD MEDICARE
MN839393OtherARAZ
IA516393Medicaid
MN260002723Medicare PIN
MN260037684OtherRAILROAD MEDICARE
MN23126OtherSIOUX VALLEY
G52983Medicare UPIN
MN829018100Medicaid