Individual provider Active NPI

Jared Gaines, M.D.

  • Psychiatry Physician
  • West Palm Beach, FL
National Provider Identifier
1063592947
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME96912 Issued in FL
Practice address
2201 45TH St
West Palm Beach, FL 33407-2047
Phone
(561) 964-7511
Fax
(561) 964-7544
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME96912 FL Primary

Addresses

Primary practice location

2201 45TH St
West Palm Beach, FL 33407-2047

Mailing address

5503 S Congress Ave
Suite 205
Atlantis, FL 33462-6625
Phone (561) 964-7511

Other identifiers 1

IdentifierTypeStateIssuer
000358500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090206000451 FL Practitioner - Psychiatry 5991860900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Florida College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Lauderdale Hospital IncGroup PAC ID 7911983853, 10 clinicians

Practice addresses (Care Compare)

5757 N Dixie Hwy
Oakland Park, FL 33334-4135
Phone (954) 734-2000

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073

Merit-based Incentive Payment System (MIPS)

Final score
95.64 of 100Reported as group
Quality
69.31
Improvement activities
40
Cost
97.77

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Lauderdale Hospital Inc. Psychiatry CurrentSince Aug 20, 2019 Accepting new patients
Northwest Behavioral Health Services, Inc. Past Accepting new patients

Locations

5757 N Dixie Hwy
Oakland Park, FL 33334
Phone (954) 463-4321

Interoperability endpoints

  • Direct secure messaging: jared.gaines@hca4.eclinicaldirectplus.com

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1063592947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5503 S CONGRESS AVE",
            "address_2": "SUITE 205",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626625",
            "telephone_number": "561-964-7511",
            "fax_number": "561-964-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 45TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072047",
            "telephone_number": "561-964-7511",
            "fax_number": "561-964-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "JARED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME96912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000358500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.