NPIMap

Individual provider Active NPI

Shashank Jain, M.D.

  • Student in an Organized Health Care Education/Training Program
  • New Haven, CT
National Provider Identifier
1174865653
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
20 York St
New Haven, CT 06510
Phone
(203) 688-4242
NPI assigned
Mar 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 277768 MA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510

Mailing address

20 York St Dept of
New Haven, CT 06510-3220
Phone (203) 688-4242

Other practice location 1

150 Bergen St
Room I-248
Newark, NJ 07103-2496
Phone (973) 972-6056

Other practice location 2

150 Bergen St
Room I-248
Newark, NJ 07103-2496
Phone (973) 972-6056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190228001290 MA Practitioner - Internal Medicine 7113266651 Reassigns benefits to 1 organization
I20210610000706 OH Practitioner - Cardiovascular Disease (Cardiology) 7113266651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

6525 Powers Blvd
Parma, OH 44129-5461
Phone (440) 743-4748

Hospital & facility affiliations

  • Parma Community General Hospital Hospital, Parma, OH, CCN 360041
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • University Hospitals Samaritan Medical Center Hospital, Ashland, OH, CCN 360002
  • Uh St John Medical Center Hospital, Westlake, OH, CCN 360123
  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
277768MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Aug 1, 2021 Accepting new patients
University Primary Care Practices Inc Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
Sound Physicians of Massachusetts Inc Internal Medicine Current Accepting new patients
Sound Physicians of Massachusetts, Inc Internal Medicine CurrentSince Feb 1, 2019 Accepting new patients
Sound Physicians of Massachusetts, Inc Internal Medicine CurrentSince Feb 1, 2019 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

6525 Powers Blvd
Parma, OH 44129
Phone (330) 242-4020

Interoperability endpoints

  • Direct secure messaging: sjain36436@ehrdirect.uhhospitals.org

Organizations & group practices 8

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1174865653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST DEPT OF",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Bergen St",
            "address_2": "Room I-248",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032496",
            "country_code": "US",
            "telephone_number": "973-972-6056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Bergen St",
            "address_2": "Room I-248",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032496",
            "country_code": "US",
            "telephone_number": "973-972-6056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SHASHANK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "277768",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.