NPIMap

Individual provider Active NPI

Manasvi Jaitly, MD

  • Nephrology Physician
  • Ogdensburg, NY
National Provider Identifier
1205036878
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
268972 Issued in NY
Practice address
3 Lyon Place
Suite 200
Ogdensburg, NY 13669-2590
Phone
(315) 394-7542
Fax
(866) 506-5573
NPI assigned
Jul 23, 2007
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 268972 NY Primary

Addresses

Primary practice location

3 Lyon Place
Suite 200
Ogdensburg, NY 13669-2590

Mailing address

3 Lyon Place
Suite 200
Ogdensburg, NY 13669-2590
Phone (315) 394-7542

Other identifiers 1

IdentifierTypeStateIssuer
02910378MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071113000093 NY Practitioner - Internal MedicinePractitioner - Nephrology 9931297751 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Claxton-Hepburn Medical CenterGroup PAC ID 8426966508, 78 clinicians
Carthage Area Hospital IncGroup PAC ID 9931010485, 119 clinicians
Claxton Medical PCGroup PAC ID 0244389153, 5 clinicians

Practice addresses (Care Compare)

100 Horwood PL
Ogdensburg, NY 13669-4510
Phone (315) 394-9462

1001 W St
Carthage, NY 13619-9703
Phone (315) 493-1000

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

2263 State Hwy 310
Madrid, NY 13660-3224
Phone (315) 322-8947

3 Lyon PL
Suite 302
Ogdensburg, NY 13669-2546
Phone (315) 393-7955

38 Hospital Dr
Massena, NY 13662-1018
Phone (315) 394-7542

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
268972NYMDNephrology Physician
002885NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Claxton Medical PC CurrentSince May 1, 2009 Accepting new patients
Carthage Area Hospital Inc CurrentSince Mar 7, 2025 Accepting new patients
Carthage Area Hospital Inc Current Accepting new patients
Claxton Medical PC Nephrology CurrentSince May 1, 2009 Accepting new patients
Claxton-Hepburn Medical Center CurrentSince Sep 4, 2007 Accepting new patients
Carthage Area Hospital Inc. Past Accepting new patients

Locations

39 W Main St
Canton, NY 13617
Phone (315) 379-4700

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

124 Ford Ave
Ogdensburg, NY 13669
Phone (315) 394-9718

214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660

3 Lyon Pl
Ogdensburg, NY 13669
Phone (315) 394-7542

3 Lyon Pl
Ste 200
Ogdensburg, NY 13669
Phone (315) 394-7542

3 Lyon Pl
Ste 302
Ogdensburg, NY 13669
Phone (315) 393-7955

Interoperability endpoints

  • Direct secure messaging: manasvi.jaitly@claxton.eclinicaldirectplus.com
  • Direct secure messaging: mjaitly@cahclinics.medentdirect.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1205036878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LYON PLACE",
            "address_2": "SUITE 200",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692590",
            "telephone_number": "315-394-7542",
            "fax_number": "866-506-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LYON PLACE",
            "address_2": "SUITE 200",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692590",
            "telephone_number": "315-394-7542",
            "fax_number": "866-506-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAITLY",
        "first_name": "MANASVI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "268972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02910378",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

Verify at the official NPI Registry.