Individual provider Active NPI

Deepanshu Jain, M.D.

  • Gastroenterology Physician
  • Celebration, FL
National Provider Identifier
1215377247
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME154899 Issued in FL
Practice address
410 Celebration PL Ste 106
Celebration, FL 34747-5432
Phone
(407) 303-4829
Fax
(407) 303-4851
NPI assigned
Jul 5, 2013
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT204096 PA
Gastroenterology Physician 207RG0100X 85072 GA
Gastroenterology Physician 207RG0100X ME154899 FL Primary

Addresses

Primary practice location

410 Celebration PL Ste 106
Celebration, FL 34747-5432

Mailing address

410 Celebration PL Ste 106
Celebration, FL 34747-5432
Phone (407) 303-4829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20200701001050 GA Practitioner - Gastroenterology 1951643782 Reassigns benefits to 2 organizations
I20220524002122 FL Practitioner - Gastroenterology 1951643782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy57
Upper gastrointestinal (GI) endoscopy for acid reflux413

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85072GAMDGastroenterology Physician
MT204096PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Aga Professional Services, LLC Gastroenterology CurrentSince May 1, 2020 Accepting new patients
Aga, LLC Gastroenterology CurrentSince May 1, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jun 6, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jun 6, 2022 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2415 N Orange Ave
Ste 700
Orlando, FL 32804
Phone (407) 303-2474

8855 Hospital Dr
Ste 101
Douglasville, GA 30134
Phone (678) 784-5020

144 Bill Carruth Pkwy
Ste 3600
Hiram, GA 30141
Phone (678) 466-5500

76 Highland Pavilion Ct
Ste 161
Hiram, GA 30141
Phone (419) 410-3352

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

488 Kennesaw Ave NW
Ste 150
Marietta, GA 30060
Phone (770) 427-3075

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5671 Peachtree Dunwoody Rd
Ste 511
Sandy Springs, GA 30342

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: djain667443@adventhealth.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/

Organizations & group practices 4

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 6

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": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1215377247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 106",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475432",
            "telephone_number": "407-303-4829",
            "fax_number": "407-303-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 106",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475432",
            "telephone_number": "407-303-4829",
            "fax_number": "407-303-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "DEEPANSHU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT204096",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "85072",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME154899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.