Individual provider Active NPI

Sarada Jaimungal, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Merrick, NY
National Provider Identifier
1104055227
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
303507 Issued in NY
Practice address
2209 Merrick Rd Ste 100
Merrick, NY 11566-4770
Phone
(516) 546-5000
Fax
(516) 546-0596
NPI assigned
Jul 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 26142 WV
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 303507 NY Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 26142 WV

Addresses

Primary practice location

2209 Merrick Rd Ste 100
Merrick, NY 11566-4770

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3000

Other identifiers 2

IdentifierTypeStateIssuer
WV5791AMedicaidWV
3810029652OtherWVMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20201209000803 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 1850600602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

101 Saint Andrews LN
Suite 1
Glen Cove, NY 11542-2254
Phone (516) 674-1812

Hospital & facility affiliations

  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26142WVMDEndocrinology, Diabetes & Metabolism Physician
303507NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine CurrentSince Aug 19, 2020 Accepting new patients
Mount Sinai School of Medicine CurrentSince Aug 19, 2020 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 8, 2022 Accepting new patients
Mount Sinai School of Medicine Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Aug 8, 2022 Accepting new patients

Locations

101 Saint Andrews Ln
Fl 1
Glen Cove, NY 11542
Phone (516) 674-1812

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

2209 Merrick Rd
Ste 100
Merrick, NY 11566
Phone (516) 371-5800

2209 Merrick Rd
Ste 201
Merrick, NY 11566
Phone (516) 546-5000

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: saradajaimungal@nslijmedgr.allscriptsdirect.net
  • Direct secure messaging: saradajaimungal@arh.medalliesdirect.net

Organizations & group practices 5

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 2

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": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1104055227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 MERRICK RD STE 100",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664770",
            "telephone_number": "516-546-5000",
            "fax_number": "516-546-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIMUNGAL",
        "first_name": "SARADA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WV",
            "license": "26142",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "303507",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WV",
            "license": "26142",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WV5791A",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "3810029652",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.