Jay S Schachne, MD – Cardiovascular Disease Physician

Key facts

NPI: 1114968286
Entity type: Individual (NPI type 1)
Primary specialty: Cardiovascular Disease Physician 207RC0000X
License: MD06705 (RI)
Practice address: 1800 Main Rd
Tiverton, RI 02878-4625
Phone: (508) 973-9700
Fax: (508) 674-7378
NPI assigned: Jun 9, 2006
Sex: Male
Sole proprietor: No

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.

Southcoast Physicians Group, Inc. Family Medicine Physician · Fairhaven, MA · NPI 1336137629

Medicare reassignment NPD RI
Truesdale Cardiology Assoc Inc Cardiovascular Disease Physician · Fall River, MA · NPI 1194762989

NPD Authorized official CARDIOVASCULAR DISEASE

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Southcoast Hospitals Group, Inc General Acute Care Hospital · Fall River, MA · NPI 1306871223

CMS ownership CORPORATE OFFICER
Southcoast Hospitals Group, Inc General Acute Care Hospital · New Bedford, MA · NPI 1447275037

CMS ownership CORPORATE OFFICER
Southcoast Hospitals Group, Inc General Acute Care Hospital · Wareham, MA · NPI 1922024835

CMS ownership CORPORATE OFFICER
Southcoast Hospitals Group,Inc Rehabilitation Hospital Unit · Fall River, MA · NPI 1750301636

CMS ownership CORPORATE OFFICER

Medicare participation

Medicare fee-for-service enrollment: Enrolled in RI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facility	Type	Role	Since
St. Luke'S Hospital New Bedford, MA · CCN 22007401	Hospital	Corporate Officer	Jan 1, 2022
Tobey Hospital Wareham, MA · CCN 220074	Hospital	Corporate Officer	Jan 1, 2022
Southcoast Hospitals Group Radiology Services-Linden Tree Fall River, MA · CCN 22007402	Hospital	Corporate Officer	Jan 1, 2022
Southeast Rehab at Charlton Memorial Hospital Fall River, MA · CCN 22T074	Hospital	Corporate Officer	Jan 1, 2023

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20190425000928	RI	Practitioner - Cardiovascular Disease (Cardiology)	5193626570	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Truesdale Cardiology Assoc Inc	Cardiovascular Disease	Current since Jan 1, 1987	Accepting new patients
Southcoast Physicians Group, Inc.		Current since Apr 1, 2019	Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

1030 President Ave
Ste 3001
Fall River, MA 02720
Phone (508) 676-3411

1030 President Ave
Fall River, MA 02720
Phone (508) 235-6427

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

1800 Main Rd
Tiverton, RI 02878
Phone (401) 624-1400

1334 Main Rd
Tiverton, RI 02878
Phone (401) 625-5552

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Cardiovascular Disease Physician	207RC0000X	54312	MA
Cardiovascular Disease Physician	207RC0000X	MD06705	RI	Yes

Addresses

Primary practice location

1800 Main Rd
Tiverton, RI 02878-4625

Mailing address

200 Mill Rd
Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Other identifiers

Identifier	Type	State	Issuer
0003572	Other	MA	NEIGHBORHOOD HEALTH
200744	Other	RI	BLUE CHIP
531911	Other	MA	AETNA US HEALTH CARE
6191339	Medicaid	MA
MA0014844	Other	MA	TRICARE
060016807	Other	MA	RAILROAD MEDICARE
3084	Other	MA	HARVARD PILGRIM
46361	Other	RI	RI BLUE SHIELD
JS08267	Other	RI	EDS
054312	Other	MA	TUFTS HEALTH PLAN
2501000	Other	MA	UNITED HEALTH CARE
J04356	Other	MA	BLUE SHIELD
000000022176	Other	MA	BMC HEALTHNET

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	jschachne6342@direct.southcoast.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 27, 2020.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1114968286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "address_2": "SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MAIN RD",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028784625",
            "telephone_number": "508-973-9700",
            "fax_number": "508-674-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHACHNE",
        "first_name": "JAY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "54312",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "MD06705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0003572",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "200744",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTH CARE",
            "identifier": "531911",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6191339",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "MA0014844",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060016807",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "3084",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE SHIELD",
            "identifier": "46361",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDS",
            "identifier": "JS08267",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "054312",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2501000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "J04356",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "000000022176",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jschachne6342@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "1800 Main Rd",
            "city": "Tiverton",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028784625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.