Organization Active NPI

Jaideep Puri MD PLLC

  • Nephrology Physician
  • Jupiter, FL
National Provider Identifier
1467860106
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
JAIDEEP PURI MD PLLC
Practice address
221 Greenwich Cir
Suite 110
Jupiter, FL 33458-2890
Phone
(561) 694-1021
Fax
(561) 694-1908
NPI assigned
Jul 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Authorized official

Name
Miss Dawn Morgan
Title
Credentialing Coordinator
Phone
(941) 953-7451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

221 Greenwich Cir
Suite 110
Jupiter, FL 33458-2890

Mailing address

221 Greenwich Cir
Suite 110
Jupiter, FL 33458-2890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150130000350 FL Part B Supplier - Clinic/Group Practice 8921322553 Receives reassigned benefits from 1 practitioner
Practice locations: Jupiter, FL

National Provider Directory

National Provider Directory

Locations

1701 Military Trl
Ste 140
Jupiter, FL 33458
Phone (561) 744-4661

221 Greenwich Cir
#110
Jupiter, FL 33458
Phone (561) 694-1021

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBJHCA

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1467860106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 GREENWICH CIR",
            "address_2": "SUITE 110",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 GREENWICH CIR",
            "address_2": "SUITE 110",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582890",
            "telephone_number": "561-694-1021",
            "fax_number": "561-694-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAIDEEP PURI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "941-953-7451",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.