Active NPI
Asha Jain, MD
- Pediatrics Physician
- New Berlin, WI
National Provider Identifier
1417064932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 21731
- Practice address
- 14555 W National Ave
Suite 165
New Berlin, WI 53151-4494 - Phone
- (262) 827-3636
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 21731 | WI | Primary |
Addresses
Primary practice location
14555 W National Ave
Suite 165
New Berlin, WI 53151-4494
Mailing address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30370400 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ajain39709@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041229000205 | WI | Practitioner - Pediatric Medicine | 1557329109 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- ajain39709@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1417064932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 W GOOD HOPE RD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532092042",
"telephone_number": "414-352-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14555 W NATIONAL AVE",
"address_2": "SUITE 165",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531514494",
"telephone_number": "262-827-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "ASHA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "21731",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30370400",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ajain39709@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "14555 W National Ave",
"address_2": "Suite 165",
"city": "New Berlin",
"state": "WI",
"country_code": "US",
"postal_code": "531514494",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "14555 W National Ave",
"address_2": "Suite 165",
"city": "New Berlin",
"state": "WI",
"country_code": "US",
"postal_code": "531514494",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.