Individual provider Active NPI

Bernard S. Jay, M.D.

  • Diagnostic Radiology Physician
  • Madison, CT
National Provider Identifier
1376579151
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
018211 Issued in CT
Practice address
12 Downing Way
Madison, CT 06443
Phone
(952) 595-1100
Fax
(612) 294-4903
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 018211 CT Primary

Addresses

Primary practice location

12 Downing Way
Madison, CT 06443

Mailing address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone (952) 595-1301

Other identifiers 1

IdentifierTypeStateIssuer
001182112MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20090921000251 CT Practitioner - Diagnostic RadiologyPractitioner - Internal Medicine 1254355720

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018211CTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Donalsonville Hospital Inc CurrentSince Apr 1, 2019 Accepting new patients
Paul a. Aiello, MD, PC Diagnostic Radiology Past Accepting new patients

Locations

102 Hospital Cir
Donalsonville, GA 39845
Phone (229) 524-8489

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1376579151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 DOWNING WAY",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "06443",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAY",
        "first_name": "BERNARD",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "018211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001182112",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

Verify at the official NPI Registry.