Individual provider Active NPI

Suni Niranjan Jani, M.D., M.P.H.

  • Child & Adolescent Psychiatry Physician
  • Columbia, MD
National Provider Identifier
1053671313
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
D00076608 Issued in MD
Practice address
10774 Hickory Ridge Rd
Columbia, MD 21044-3646
Phone
(844) 224-5264
NPI assigned
May 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D00077608 MD
Child & Adolescent Psychiatry Physician 2084P0804X D00076608 MD Primary

Addresses

Primary practice location

10774 Hickory Ridge Rd
Columbia, MD 21044-3646

Mailing address

10810 Hickory Ridge Rd
Columbia, MD 21044-3622
Phone (410) 707-4135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190617002076 MD Practitioner - Psychiatry 4688980451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Georgetown University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Behavioral Health LLCGroup PAC ID 2567693849, 8 clinicians

Practice addresses (Care Compare)

10774 Hickory Ridge Rd
Columbia, MD 21044-3646
Phone (877) 224-5264

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D00077608MDMDPsychiatry Physician
D00076608MDMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Behavioral Health, LLC CurrentSince Aug 9, 2021 Accepting new patients

Locations

426 Dorchester Ave
Cambridge, MD 21613
Phone (410) 228-3929

106 Lee St
Salisbury, MD 21804

809 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 334-6687

817 Eastern Shore Dr
Salisbury, MD 21804

Organizations & group practices 2

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": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1053671313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 HICKORY RIDGE RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443622",
            "telephone_number": "410-707-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10774 HICKORY RIDGE RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443646",
            "telephone_number": "844-224-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANI",
        "first_name": "SUNI",
        "middle_name": "NIRANJAN",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D00077608",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D00076608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.