Individual provider Active NPI

Nelia Jain, M.D.

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1174844682
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME164458 Issued in FL
Practice address
880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027
Phone
(866) 849-0692
NPI assigned
Jun 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.149713 OH
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 50046 AL
Internal Medicine Physician 207R00000X U6981 TX
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 276532 MA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 102486 GA
Internal Medicine Physician 207R00000X ME164458 FL Primary

Addresses

Primary practice location

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Other practice location 1

450 Brookline Ave
Boston, MA 02215-5418
Phone (617) 632-2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL, AL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180906000194 MA Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 3577702539 Reassigns benefits to 2 organizations
I20240531003687 FL Practitioner - Internal Medicine 3577702539 Reassigns benefits to 1 organization
I20250124000363 AL Practitioner - Internal Medicine 3577702539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME164458FLMDInternal Medicine Physician
102486GAMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Aug 1, 2018 Accepting new patients
Devoted Medical Group Professional Corporation CurrentSince May 16, 2024 Accepting new patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Thyme Care Medical PLLC CurrentSince Oct 1, 2025 Accepting new patients
Bobby Green Medical, P.C. PastSince Jan 29, 2023 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

880 SW 145th Ave
Ste 202
Pembroke Pines, FL 33027
Phone (615) 275-6612

75 Francis St
Boston, MA 02115

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

10 Lea Ave
Ste 760
Nashville, TN 37210
Phone (210) 526-8484

Interoperability endpoints

  • Direct secure messaging: nelia.jain@532070890209284.direct.elationemr.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1174844682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33027",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155418",
            "country_code": "US",
            "telephone_number": "617-632-2027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "NELIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.149713",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "AL",
            "license": "50046",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U6981",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MA",
            "license": "276532",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "102486",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME164458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.