NPIMap

Individual provider Active NPI

Neelu Jain, MD

  • Neuroradiology Physician
  • Philadelphia, PA
National Provider Identifier
1568407302
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
MD461234 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-7237
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X MD461234 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-7237

Other identifiers 1

IdentifierTypeStateIssuer
9020004MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20201102001600 PA Practitioner - Diagnostic Radiology 2668578816 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD461234PAMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Oct 1, 2020 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Oct 1, 2020 Accepting new patients
Jeanes Radiology Associates LLC Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Rittenhouse Imaging Center, LLC Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Lebanon Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Insight Health Corp PastSince Sep 1, 2022 Accepting new patients
New Jersey Diagnostic Imaging & Therapy Inc Diagnostic Radiology Past Accepting new patients
Toms River Xray CT and MRI Center PA Diagnostic Radiology PastSince Jul 11, 1990 Accepting new patients
New Jersey Diagnostic Imaging & Therapy, PA Past Accepting new patients

Locations

462 Gateway Ave
Chambersburg, PA 17201
Phone (717) 263-4999

150 E Pennsylvania Ave
Downingtown, PA 19335
Phone (215) 772-9674

2365 Heritage Center Dr
Furlong, PA 18925
Phone (215) 728-3883

8305 Ridge Ave
Philadelphia, PA 19128
Phone (215) 381-5886

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

Organizations & group practices 10

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 9

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1568407302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "NEELU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "MD461234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9020004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.