NPIMap

Individual provider Active NPI

Sirisha Maddipoti Jain, MD

  • Hematology & Oncology Physician
  • Bremerton, WA
National Provider Identifier
1437343035
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD60244388 Issued in WA
Practice address
2720 Clare Ave
Suite a
Bremerton, WA 98310-3374
Phone
(360) 479-6154
Fax
(360) 479-5728
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M6736 TX
Hematology & Oncology Physician 207RH0003X MD60244388 WA Primary

Addresses

Primary practice location

2720 Clare Ave
Suite a
Bremerton, WA 98310-3374

Mailing address

2520 Cherry Ave
Bremerton, WA 98310-4229
Phone (360) 479-6154

Other identifiers 1

IdentifierTypeStateIssuer
8AQ630OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000282 WA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7517046303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

909 University St
FL 2
Seattle, WA 98101-2772
Phone (206) 341-0687

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6736TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group Internal Medicine CurrentSince Jul 2, 2017 Accepting new patients
Harrison Medical Center Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

2720 Clare Ave
Ste A
Bremerton, WA 98310
Phone (360) 479-6154

19500 10th Ave NE
Ste 100
Poulsbo, WA 98370
Phone (360) 598-7500

1900 NW Myhre Rd
Silverdale, WA 98383
Phone (564) 240-3100

1780 NW Myhre Rd
Ste 1220
Silverdale, WA 98383
Phone (360) 337-6500

9633 Levin Rd NW
Ste 103
Silverdale, WA 98383
Phone (360) 337-8200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1437343035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 CHERRY AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104229",
            "telephone_number": "360-479-6154",
            "fax_number": "360-479-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 CLARE AVE",
            "address_2": "SUITE A",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103374",
            "telephone_number": "360-479-6154",
            "fax_number": "360-479-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SIRISHA",
        "middle_name": "MADDIPOTI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M6736",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WA",
            "license": "MD60244388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8AQ630",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.