NPIMap

Individual provider Active NPI

Rajiv Jain, MD

  • Internal Medicine Physician
  • Tonawanda, NY
National Provider Identifier
1568436004
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
221199 Issued in NY
Practice address
1491 Sheridan Dr
Tonawanda, NY 14217-1234
Phone
(716) 332-4476
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 221199 NY Primary
Sports Medicine (Internal Medicine) Physician 207RS0010X 221199 NY

Addresses

Primary practice location

1491 Sheridan Dr
Tonawanda, NY 14217-1234

Mailing address

1491 Sheridan Dr
Tonawanda, NY 14217-1234
Phone (716) 332-4476

Other identifiers 1

IdentifierTypeStateIssuer
02165277MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040423000050 NY Practitioner - Internal MedicinePractitioner - Sports MedicinePractitioner - Pediatric Medicine 7517879075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine, Sports Medicine
Education
State University of New York at Buffalo School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Orthopaedic Services Inc.Group PAC ID 7810983004, 115 clinicians
Sheridan Drive Medical Group LLPGroup PAC ID 8820900376, 9 clinicians

Practice addresses (Care Compare)

1491 Sheridan Dr
Tonawanda, NY 14217-1234
Phone (716) 332-4476

Hospital & facility affiliations

  • McAuley Seton Home Care Corp Chha Home health agency, Buffalo, NY, CCN 337251
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Kenmore Mercy Hospital Hospital, Kenmore, NY, CCN 330102
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221199NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopaedic Services Inc. CurrentSince Nov 15, 2003 Accepting new patients
University Orthopaedic Services, Inc CurrentSince Nov 15, 2003 Accepting new patients
Sheridan Drive Medical Group LLP Internal Medicine CurrentSince Jan 1, 2003 Accepting new patients
Geriatric Associates, LLP PastSince Jul 25, 2019 Accepting new patients

Locations

160 Farber Hall
Buffalo, NY 14214
Phone (716) 829-2070

4949 Harlem Rd
Buffalo, NY 14226
Phone (716) 204-3201

1491 Sheridan Dr
Ste 100
Tonawanda, NY 14217
Phone (716) 332-4476

1491 Sheridan Dr
Tonawanda, NY 14217
Phone (716) 332-4476

111 N Maplemere Rd
Ste 100
Williamsville, NY 14221
Phone (716) 810-7997

Interoperability endpoints

  • Direct secure messaging: rjain@sheridanmedgroup.medentdirect.com
  • FHIR API: https://fhir.medent.com/fhir/R4/3P171181
  • Direct secure messaging: rjain@ubortho.medentdirect.com

Organizations & group practices 4

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 10

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1568436004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142171234",
            "telephone_number": "716-332-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142171234",
            "telephone_number": "716-332-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "RAJIV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221199",
            "primary": true
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "NY",
            "license": "221199",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02165277",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.