Active NPI
Sunanda Jain, MD
- Nephrology Physician
- Bismarck, ND
National Provider Identifier
1164514519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 9177
- Practice address
- 900 E Broadway Ave
Bismarck, ND 58501-4520 - Phone
- (701) 530-7000
- Fax
- (701) 530-6536
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 9177 | ND | Primary |
Addresses
Primary practice location
900 E Broadway Ave
Bismarck, ND 58501-4520
Mailing address
PO Box 997
Bismarck, ND 58502-0997
Phone (701) 530-6500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12377 | Medicaid | ND | |
| P00011525 | Other | ND | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 83.48 of 100
- Quality
- 73.03
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.91
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9177 | ND | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Alexius Medical Center | Current | Accepting new patients | |
| St Alexius Medical Center | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300
Interoperability endpoints
- sjain128366@achce.catholichealth.net
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1164514519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 997",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585020997",
"telephone_number": "701-530-6500",
"fax_number": "701-530-6536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 E BROADWAY AVE",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585014520",
"telephone_number": "701-530-7000",
"fax_number": "701-530-6536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "SUNANDA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "ND",
"license": "9177",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12377",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00011525",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.