Jyotibala Jain, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

590833 Issued in TX

Practice address

163 Van Buren Rd
Caribou, ME 04736-3567

Phone

(214) 648-3538

NPI assigned

Aug 11, 2015

Last updated

Jun 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjain577109@direct.ochin.org

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.

• Pines Health Services

  • Internal Medicine Physician
  • Caribou, ME
  • NPI 1942277819

  Pediatrics

  Medicare reassignment NPD
• Pines Health Services

  dba Washburn Health Center

  • Federally Qualified Health Center (FQHC)
  • Washburn, ME
  • NPI 1922449834
  NPD
• City of Caribou

  dba Cary Medical Center

  • General Acute Care Hospital
  • Caribou, ME
  • NPI 1780615492
  NPD (past)
• Pines Health Services

  dba Women and Childrens Center

  • Obstetrics & Gynecology Physician
  • Caribou, ME
  • NPI 1528383262

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1609252808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 VAN BUREN RD",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047363567",
            "telephone_number": "214-648-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "JYOTIBALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "590833",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD25067",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia C Hudson, PHARMD
• Rebekah Ann Hunt, LCSW
• Inner Balance, LLC
• Ayodele T Isaacs, MD
• Christopher W Jackson, ATC, CEAS
• Daniel Joseph Jandreau, O.D.
• Jonathan Herland D SC MD PA
• Regina Ann Jones-Morneault, RPH
• Jeffrey Joseph
• Anne Kane, LMSWCC

• Student in an Organized Health Care Education/Training Program in Caribou, ME
• Providers in Caribou, ME by specialty
• Student in an Organized Health Care Education/Training Program in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.