Individual provider Active NPI

Gaurav Jain, MD

  • Internal Medicine Physician
  • Williamsville, NY
National Provider Identifier
1447416979
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
273927 Issued in NY
Practice address
400 International Dr.
Williamsville, NY 14221
Phone
(716) 631-3555
Fax
(716) 631-9525
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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 273927 NY Primary
Psychiatry Physician 2084P0800X 273927 NY

Addresses

Primary practice location

400 International Dr.
Williamsville, NY 14221

Mailing address

400 International Dr.
Williamsville, NY 14221
Phone (716) 631-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160831000836 MA Practitioner - Pain Management 2264673748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

725 N St
Pittsfield, MA 01201-4109
Phone (413) 447-2695

725 N Street Berkshire OB/GYN of
Mbu
Pittsfield, MA 01201-4109
Phone (413) 499-8570

777 N St
Pittsfield, MA 01201-4147

777 N St 6 FL
Surgical Profession
Pittsfield, MA 01201-4147
Phone (413) 447-2745

777 N St 6TH Floor
Pittsfield, MA 01201-4147

780 S Main St
Suite 2
Great Barrington, MA 01230-2149
Phone (413) 447-2498

Hospital & facility affiliations

  • Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046
  • North Adams Regional Hospital Corporation Hospital, North Adams, MA, CCN 221304
  • Fairview Hospital Hospital, Great Barrington, MA, CCN 221302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273927NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Jul 5, 2016 Accepting new patients
Berkshire Faculty Services Inc CurrentSince Jul 5, 2016 Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

Interoperability endpoints

  • Direct secure messaging: gauravjain@bfs.medalliesdirect.net

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.

Hospital & facility affiliations 3

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1447416979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR.",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-631-3555",
            "fax_number": "716-631-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR.",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-631-3555",
            "fax_number": "716-631-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "GAURAV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "273927",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "273927",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.