Individual provider Active NPI

Sanjiv K Jain, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Encino, CA
National Provider Identifier
1477594067
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A47841 Issued in CA
Practice address
16101 Ventura Blvd
Ste 240
Encino, CA 91436-2513
Phone
(818) 366-0474
Fax
(818) 360-6319
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A47841 CA
Internal Medicine Physician 207R00000X A47841 CA
Pain Medicine (Anesthesiology) Physician 207LP2900X A47841 CA Primary

Addresses

Primary practice location

16101 Ventura Blvd
Ste 240
Encino, CA 91436-2513

Mailing address

P.O. Box 8000
Northridge, CA 91327-8000
Phone (818) 366-0474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A47841CAMDInternal Medicine Physician
ME0066806FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Encino Place Pain Management and Surgery Center, Inc. Current Accepting new patients
Encino Place Pain Management and Surgery Center Inc Current Accepting new patients
LMR Imaging Past Accepting new patients

Locations

16101 Ventura Blvd
Ste 240
Encino, CA 91436
Phone (818) 366-0474

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1477594067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 8000",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913278000",
            "telephone_number": "818-366-0474",
            "fax_number": "818-474-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD",
            "address_2": "STE 240",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362513",
            "telephone_number": "818-366-0474",
            "fax_number": "818-360-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SANJIV",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A47841",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A47841",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A47841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.