Active NPI
Sunita K. Jain, M.D.
- Family Medicine Physician
- Oceanside, NY
National Provider Identifier
1487649257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 209803
- Practice address
- 196 Merrick Rd
Oceanside, NY 11572-1420 - Phone
- (516) 255-8400
- Fax
- (516) 255-8453
- NPI assigned
- Sep 16, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 209803 | NY | Primary |
Addresses
Primary practice location
196 Merrick Rd
Oceanside, NY 11572-1420
Mailing address
1 Healthy Way
Attn: Physician Billing
Oceanside, NY 11572-1551
Phone (516) 255-1600
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000027876 | Other | NY | AFFINITY |
| 3C3275 | Other | NY | HEALTHNET |
| 000000072442 | Other | NY | GHI HMO |
| 2128487 | Other | NY | UNITED HEALTHCARE |
| 01919460 | Medicaid | NY | |
| 040426009475 | Other | NY | FIDELIS |
| 5997924 | Other | NY | GHI PPO |
| 135337 | Other | NY | AETNA HMO |
| 5090A1 | Other | NY | BCBS |
| 5841688 | Other | NY | AETNA PPO |
| 209803 | Other | NY | HIP |
| 3134504 | Other | NY | CIGNA |
| P2471796 | Other | NY | OXFORD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 209803 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jain & Kanumilli,MD,PC | Family Medicine | Past | Accepting new patients |
| Thomas W Hodyl, MD PC | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Floral Park, NY
- NPI 1760463020
-
- General Practice Physician
- Copiague, NY
- NPI 1558524959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487649257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HEALTHY WAY",
"address_2": "ATTN: PHYSICIAN BILLING",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115721551",
"telephone_number": "516-255-1600",
"fax_number": "516-255-4672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 MERRICK RD",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115721420",
"telephone_number": "516-255-8400",
"fax_number": "516-255-8453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "SUNITA",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "209803",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AFFINITY",
"identifier": "1000027876",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "3C3275",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI HMO",
"identifier": "000000072442",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2128487",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01919460",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "040426009475",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PPO",
"identifier": "5997924",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "135337",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5090A1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5841688",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "209803",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3134504",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2471796",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oceanside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.