Active NPI
Sanjay S. Jain, MD
- Pulmonary Disease Physician
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 01060078A
- Practice address
- 7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140 - Phone
- (260) 432-2297
- Fax
- (260) 434-6481
- NPI assigned
- Mar 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 01060078A | IN | |
| Pulmonary Disease Physician | 207RP1001X | 01060078A | IN | Primary |
Addresses
Primary practice location
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Mailing address
6920 Pointe Inverness Way Ste 200
Medpartners, Attn: Barb Copeland
Fort Wayne, IN 46804-7934
Phone (260) 479-3514
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000354843 | Other | IN | ANTHEM |
| P00191330 | Other | RAILROAD | |
| 2538016 | Medicaid | OH | |
| 200506290 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sanjay.jain@lutheranhealthnetwork.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1035 W Wayne St
Paulding, OH 45879-1544
Phone (419) 399-4080
2510 E Dupont Rd
Suite 206
Fort Wayne, IN 46825-1602
Phone (260) 416-5954
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Hospital & facility affiliations
- Lutheran Hospital of Indiana
- Dupont Hospital LLC
- Cameron Health
- Bluffton Regional Medical Center
- Kosciusko Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.99 of 100
- Quality
- 77.41
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01060078A | IN | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Medical Group LLC | Current | Accepting new patients | |
| Lutheran Medical Group LLC | Pulmonary Disease | Current | Accepting new patients |
| Curators of the University of Missouri | Past | Accepting new patients |
Locations
516 E Maumee St
Ste C
Angola, IN 46703
955 High St
Ste 3
Decatur, IN 46733
Phone (219) 724-2125
6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514
2510 E DuPont Rd
Ste 206
Fort Wayne, IN 46825
Phone (260) 416-5954
3534 Brooklyn Ave
Fort Wayne, IN 46809
Phone (219) 478-5180
7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298
2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076
1035 W Wayne St
Paulding, OH 45879
Phone (419) 399-4080
1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077
Interoperability endpoints
- sanjay.jain@lutheranhealthnetwork.cernerdirect.com
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.
-
- Cardiovascular Disease Physician
- Fort Wayne, IN
- NPI 1164662805
OH, Pulmonary Disease
-
- Durable Medical Equipment & Medical Supplies
- Fort Wayne, IN
- NPI 1710275664
-
- Community/Retail Pharmacy
- Jefferson City, MO
- NPI 1740083641
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bluffton, IN
- NPI 1376594366
-
- Critical Access Hospital
- Angola, IN
- NPI 1386683316
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1538110556
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1306897335
-
- General Acute Care Hospital
- Warsaw, IN
- NPI 1164475711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601337600000",
"number": "1205803632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6920 POINTE INVERNESS WAY STE 200",
"address_2": "MEDPARTNERS, ATTN: BARB COPELAND",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047934",
"telephone_number": "260-479-3514",
"fax_number": "260-479-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7916 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044140",
"telephone_number": "260-432-2297",
"fax_number": "260-434-6481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "SANJAY",
"middle_name": "S.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-03",
"last_updated": "2020-09-29",
"certification_date": "2020-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "IN",
"license": "01060078A",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IN",
"license": "01060078A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000354843",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00191330",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2538016",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200506290",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sanjay.jain@lutheranhealthnetwork.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "AMR direct address",
"address_1": "7916 W Jefferson Blvd",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468044140",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.