Active NPI
Sargam Jain, M.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1114184173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 247098
- Practice address
- 31 West 10TH Street
Suite 2C
New York, NY 10011 - Phone
- (212) 677-2985
- Fax
- (347) 478-5068
- NPI assigned
- May 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 247098 | NY | Primary |
Addresses
Primary practice location
31 West 10TH Street
Suite 2C
New York, NY 10011
Mailing address
11 5TH Ave Ofc 7
New York, NY 10003-4342
Phone (917) 318-3691
Other practice location 1
11 5th Ave Ofc 7
New York, NY 10003-4342
Phone (917) 318-3691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 22, 2015 through Dec 22, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 247098 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jain and Kopelman Psychiatry, LLP | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- New York, NY
- NPI 1043551443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581984000000",
"number": "1114184173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 5TH AVE OFC 7",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100034342",
"telephone_number": "917-318-3691",
"fax_number": "347-478-5068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 WEST 10TH STREET",
"address_2": "SUITE 2C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10011",
"telephone_number": "212-677-2985",
"fax_number": "347-478-5068"
}
],
"practiceLocations": [
{
"address_1": "11 5th Ave Ofc 7",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100034342",
"country_code": "US",
"telephone_number": "917-318-3691",
"fax_number": "347-478-5068",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAIN",
"first_name": "SARGAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-19",
"last_updated": "2020-02-18",
"certification_date": "2020-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "247098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.