Jay Mahadevan Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JAY MAHADEVAN INC

Practice address

3535 S Jefferson Ave
Suite 304
St Louis, MO 63118

Phone

(314) 865-6585

Fax

(314) 865-6599

NPI assigned

Sep 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jay Mahadevan, MD

Title

President

Phone

(314) 865-6582

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jambunathan Mahadevan, MD

  • Internal Medicine Physician
  • St Louis, MO
  • NPI 1669588638
  Medicare reassignment NPD

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1386747715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775578",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631775578",
            "telephone_number": "314-865-6582",
            "fax_number": "314-865-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S JEFFERSON AVE",
            "address_2": "SUITE 304",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63118",
            "telephone_number": "314-865-6585",
            "fax_number": "314-865-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY MAHADEVAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "MAHADEVAN",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-865-6582",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0400415",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "100656",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201582608",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nisma Javed, M.B.B.S.
• Cylen Javidan-Nejad, MD
• Mariah A Javier
• Jay F Hauser DDS PC D/B/a Premier Dental Partners
• Jay L. Liss, Incorporated
• Patrick Y Jay, MD
• Samrat Jun Jayanth, M.D.
• Ellen Marting Jayaprabhu, LMFT
• Sundeep Jayaprabhu, M.D.
• Neil George Jayarajan, MD

• Internal Medicine Physician in St Louis, MO
• Providers in St Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.