Individual provider Active NPI

Sheetal Jain, MD

  • Internal Medicine Physician
  • Red Hook, NY
National Provider Identifier
1083109722
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
312990 Issued in NY
Practice address
17 Glen Pond Dr
Red Hook, NY 12571-1840
Phone
(845) 758-9118
NPI assigned
Jun 26, 2018
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 312990 NY Primary

Addresses

Primary practice location

17 Glen Pond Dr
Red Hook, NY 12571-1840

Mailing address

17 Glen Pond Dr Ste 1
Red Hook, NY 12571-1824
Phone (845) 758-9118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210923002714 NY Practitioner - Internal Medicine 3870990435 Reassigns benefits to 1 organization
I20220527000215 MA Practitioner - Internal Medicine 3870990435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6511 Spring Brook Ave
Suite 101
Rhinebeck, NY 12572-3709
Phone (845) 331-5326

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Medical Center, Inc CurrentSince Mar 10, 2022 Accepting new patients
Nuvance Health Medical Practice PC Internal Medicine CurrentSince Nov 30, 2021 Accepting new patients
Berkshire Medical Center Inc. CurrentSince Mar 10, 2022 Accepting new patients
Northern Dutchess Hospital Past Accepting new patients

Locations

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

6511 Spring Brook Ave
Ste 101
Rhinebeck, NY 12572
Phone (845) 331-5326

Organizations & group practices 4

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.

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1083109722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 GLEN POND DR STE 1",
            "city": "RED HOOK",
            "state": "NY",
            "postal_code": "125711824",
            "telephone_number": "845-758-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 GLEN POND DR",
            "city": "RED HOOK",
            "state": "NY",
            "postal_code": "125711840",
            "telephone_number": "845-758-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SHEETAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "312990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Hook, NY

Sources for this page

Verify at the official NPI Registry.