Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jackson David Nagamoto, MD

Individual provider Internal Medicine Physician · NPI 1356043061

Jackson David Nagamoto, MD is an Internal Medicine in Philadelphia, Pennsylvania. Graduated from Univ of Central Florida, College of Medicine in 2023, 3 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Pennsylvania.

Years since qualifying
3
Trained at
Univ of Central Florida, College of Medicine
Licensed in
PA
In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3401 N Broad St
Philadelphia, PA 19140-5103
Phone: (215) 707-1622
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4510 Brockton Ave, Riverside, CA 92501-4015 — (951) 897-9896

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD493254 (PA)

Record details

NPI number1356043061
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 20, 2023
Last updated in NPPESMarch 31, 2026
Certification dateMarch 31, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIV OF CENTRAL FLORIDA, COLLEGE OF MEDICINE
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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