Shelly Gupta Jain, M.D.

Primary specialty

Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X

License

35097638 Issued in OH

Practice address

915 Olentangy River Rd
Columbus, OH 43212-3153

Phone

(614) 293-8116

Fax

(614) 293-4719

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Shelly Rani Gupta Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Specialty

Ophthalmology

Education

Northeastern Ohio University College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osu Eye Physicians and Surgeons, LLCGroup PAC ID 5698671881, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjain41814@direct.osumc.edu

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.

• Osu Eye Physicians and Surgeons LLC

  • Ophthalmology Physician
  • Columbus, OH
  • NPI 1861437923
  Medicare reassignment Care Compare group NPD

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

• Ohio State University Hospitals

  • Rehabilitation Hospital Unit
  • Columbus, OH
  • NPI 1184723637
  Care Compare affiliation
• Ohio State University Hospitals

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1447359997
  Care Compare affiliation
• Ohio State University Hospitals

  • Psychiatric Hospital Unit
  • Columbus, OH
  • NPI 1790876183
  Care Compare affiliation

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1194928184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-8116",
            "fax_number": "614-293-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123153",
            "telephone_number": "614-293-8116",
            "fax_number": "614-293-4719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432123153",
            "country_code": "US",
            "telephone_number": "614-293-8116",
            "fax_number": "614-293-3555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SHELLY",
        "middle_name": "GUPTA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35097638",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "OH",
            "license": "35097638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054348",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjain41814@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "915 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432123153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "GUPTA",
            "middle_name": "RANI",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie Jaime
• Jayanshu Jain, MD
• Prachi Ajay Jain, M.D
• Rajneesh Jain, M.D.
• Samta Jain, MD
• Sunita Jairam
• Jajay Reliable Services LLC
• Anila Shyam Jajodia, MD
• Almas Jakda, M.D.
• Rachael Jakubowski, LMT

• Glaucoma Specialist (Ophthalmology) Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Glaucoma Specialist (Ophthalmology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.

Verify at the official NPI Registry.