Organization Active NPI

Sanjay Pratap Jobanputra, MD, P.C.

  • Colon & Rectal Surgery Physician
  • Garden City, NY
National Provider Identifier
1114366408
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
236233 Issued in NY
Legal business name
SANJAY PRATAP JOBANPUTRA, MD, P.C.
Practice address
1075 Franklin Ave
Garden City, NY 11530-2930
Phone
(516) 478-4540
Fax
(516) 248-5031
NPI assigned
Jun 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Authorized official

Name
Sanjay P Jobanputra, MDNPI 1053368241
Title
President
Phone
(516) 478-4540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X 236233 NY Primary

Addresses

Primary practice location

1075 Franklin Ave
Garden City, NY 11530-2930

Mailing address

1075 Franklin Ave
Garden City, NY 11530-2930
Phone (516) 478-4540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131008001843 NY Part B Supplier - Clinic/Group Practice 0547494445 Receives reassigned benefits from 1 practitioner
Practice locations: Garden City, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371600000000",
    "number": "1114366408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302930",
            "telephone_number": "516-478-4540",
            "fax_number": "516-248-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302930",
            "telephone_number": "516-478-4540",
            "fax_number": "516-248-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANJAY PRATAP JOBANPUTRA, MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A",
        "authorized_official_last_name": "JOBANPUTRA",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-478-4540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "236233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.