Individual provider Active NPI

Sanjay K Jain, MD

  • Family Medicine Physician
  • Hackettstown, NJ
National Provider Identifier
1063455780
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA42351 Issued in NJ
Practice address
Panther Valley Mall, BLDG B, Route 517
Hackettstown, NJ 07840
Phone
(908) 852-0107
Fax
(908) 850-9160
NPI assigned
Jun 13, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA42351 NJ Primary

Addresses

Primary practice location

Panther Valley Mall, BLDG B, Route 517
Hackettstown, NJ 07840

Mailing address

Panther Valley Mall, BLDG B, Route 517
Hackettstown, NJ 07840
Phone (908) 852-0107

Other identifiers 3

IdentifierTypeStateIssuer
00918130MedicaidNY
1975102MedicaidNJ
1K1812OtherCOMMERCIAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA42351NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salerno Medical Associates, LLC PastSince Sep 6, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jain.sanjay.003.0300109@nwma.meditab.direct-ci.com
  • Direct secure messaging: jain.sanjay.004.0300109@nwma.meditab.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063455780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PANTHER VALLEY MALL, BLDG B, ROUTE 517",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "07840",
            "telephone_number": "908-852-0107",
            "fax_number": "908-850-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PANTHER VALLEY MALL, BLDG B, ROUTE 517",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "07840",
            "telephone_number": "908-852-0107",
            "fax_number": "908-850-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SANJAY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA42351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00918130",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1975102",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1K1812",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackettstown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.