Active NPI
Michael E Jay, M.D.
- Vascular & Interventional Radiology Physician
- Pawtucket, RI
National Provider Identifier
1295725042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- MD12306
- Practice address
- 111 Brewster Street
Pawtucket, RI 02860-4474 - Phone
- (401) 729-2339
- NPI assigned
- Oct 24, 2005
- 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 |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | 49166 | MA | |
| Vascular & Interventional Radiology Physician | 2085R0204X | MD12306 | RI | Primary |
Addresses
Primary practice location
111 Brewster Street
Pawtucket, RI 02860-4474
Mailing address
111 Brewster Street
Wood BLDG #516
Pawtucket, RI 02860-4474
Phone (401) 729-3481
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 049166 | Other | MA | TUFTS HEALTH PLAN |
| 344539 | Other | MA | HARVARD PILGRIM |
| J25694 | Other | MA | BCBS RI |
| 0188433 | Medicaid | MA | |
| 30013557 | Other | MA | RAILROAD MEDICARE |
| 04-3140277 | Other | MA | HCVM FIRST HEALTH |
| 04-3140277 | Other | MA | TRICARE |
| 16-00012 | Other | MA | UNITED HEALTHCARE MA |
| 410511 | Other | MA | BLUE CHIP R |
| 4642867002 | Other | MA | CIGNA MA |
| J25694 | Other | MA | BMA |
| 000000028363 | Other | MA | HEALTH NET |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1295725042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 BREWSTER STREET",
"address_2": "WOOD BLDG #516",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028604474",
"telephone_number": "401-729-3481",
"fax_number": "401-729-2721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 BREWSTER STREET",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028604474",
"telephone_number": "401-729-2339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAY",
"first_name": "MICHAEL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "MA",
"license": "49166",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "RI",
"license": "MD12306",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "049166",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "344539",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS RI",
"identifier": "J25694",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0188433",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "30013557",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HCVM FIRST HEALTH",
"identifier": "04-3140277",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "04-3140277",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE MA",
"identifier": "16-00012",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP R",
"identifier": "410511",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA MA",
"identifier": "4642867002",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMA",
"identifier": "J25694",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "000000028363",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.