NPIMap

Individual provider Active NPI

Sushil Kumar Jain, MD

  • Internal Medicine Physician
  • Medina, OH
National Provider Identifier
1538147152
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35067447 Issued in OH
Practice address
5041 Victor Dr
Unit C
Medina, OH 44256-2666
Phone
(330) 723-3338
Fax
(330) 722-5439
NPI assigned
Jan 4, 2006
Last updated
Mar 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35067447 OH Primary

Addresses

Primary practice location

5041 Victor Dr
Unit C
Medina, OH 44256-2666

Mailing address

5041 Victor Dr
Unit C
Medina, OH 44256-2666
Phone (330) 723-3338

Other identifiers 5

IdentifierTypeStateIssuer
128219100OtherOHDEPT OF LABOR
000000139189OtherOHANTHEM BCBS
0145499MedicaidOH
509460001OtherOHCARESOURCE BWC
913629100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060413000616 OH Practitioner - Internal Medicine 4486663754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sushil K Jain MD IncGroup PAC ID 7517046014, 2 clinicians

Practice addresses (Care Compare)

5041 Victor Dr C
Medina, OH 44256-6028
Phone (330) 723-3338

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.4 of 100Reported as group
Quality
73.4
Improvement activities
40
Cost
57.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35067447OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sushil K Jain MD Inc Internal Medicine CurrentSince Apr 7, 2006 Accepting new patients
Medina Hospital Past Accepting new patients
Progressive Medina LLC Past Accepting new patients
Medina BSD Opco LLC Past Accepting new patients
Ahf Ohio, Inc. Past Accepting new patients
Medina Operations, LLC Past Accepting new patients

Locations

5041 Victor Dr
Ste C
Medina, OH 44256
Phone (330) 723-3338

Interoperability endpoints

  • Direct secure messaging: sjain@e8fb7ffa.micromddirect.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Autumnwood Nursing and Rehabilitation CenterRittman, OH, CCN 365563 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025
Avenue at MedinaMedina, OH, CCN 366407 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 19, 2013
Jun 19, 2013
Samaritan Care Center and VillaMedina, OH, CCN 365817 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2016
Feb 21, 2025
Remembrance Hospice LLCMedina, OH, CCN 361729 Hospice Contracted Managing Employee Jan 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1538147152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 VICTOR DR",
            "address_2": "UNIT C",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562666",
            "telephone_number": "330-723-3338",
            "fax_number": "330-722-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 VICTOR DR",
            "address_2": "UNIT C",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562666",
            "telephone_number": "330-723-3338",
            "fax_number": "330-722-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SUSHIL",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35067447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "128219100",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000139189",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145499",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE BWC",
            "identifier": "509460001",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "913629100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.