Individual provider Active NPI

Ajay Jain, MD

  • Cardiovascular Disease Physician
  • Statesboro, GA
National Provider Identifier
1104853787
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
58253 Issued in GA
Practice address
1497 Fair Rd
Suite 305
Statesboro, GA 30458-0822
Phone
(912) 681-2273
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 58253 GA Primary

Addresses

Primary practice location

1497 Fair Rd
Suite 305
Statesboro, GA 30458-0822

Mailing address

1497 Fair Rd
Suite 305
Statesboro, GA 30458-0822
Phone (912) 681-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20061026000412 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5799782389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1497 Fair Rd
Suite 305
Statesboro, GA 30458-0828
Phone (912) 681-2273

Hospital & facility affiliations

  • East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
  • Emanuel Medical Center Hospital, Swainsboro, GA, CCN 110109
  • Candler County Hospital Hospital, Metter, GA, CCN 111334
  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Associates of Eastern Georgia Single Specialty CurrentSince Oct 1, 2006 Accepting new patients
Laser Eye Surgery of Erie, Inc Single Specialty PastSince Oct 21, 1998 Accepting new patients

Locations

1497 Fair Rd
Ste 305
Statesboro, GA 30458
Phone (912) 871-1360

122 Alice Coleman Dr
Vidalia, GA 30474
Phone (912) 805-2273

Interoperability endpoints

  • Direct secure messaging: jain.ajay.001.0100064@jaca.meditab.direct-ci.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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1104853787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD",
            "address_2": "SUITE 305",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580822",
            "telephone_number": "912-681-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD",
            "address_2": "SUITE 305",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580822",
            "telephone_number": "912-681-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "AJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "58253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.