Jennifer Lynn Maitra, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

31741 Issued in AZ

Practice address

3400 N Dysart Rd
Unit G-127
Avondale, AZ 85392-1003

Phone

(623) 882-0077

Fax

(623) 882-9977

NPI assigned

Jul 19, 2006

Last updated

Oct 11, 2012By 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 AZ

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

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.maitra.1@19654.direct.athenahealth.com

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.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment Care Compare group NPD
• Sunny Internal Medicine and Pediatrics, PLLC

  • Internal Medicine Physician
  • Avondale, AZ
  • NPI 1376723916
  Authorized official Same address or phone
• Arizona Primary Care Physicians, LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1033523949
  NPD

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

• Banner Home Care-Arizona

  • Home Health Agency
  • Sun City, AZ
  • NPI 1023051927
  Care Compare affiliation

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1619996535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 N DYSART RD",
            "address_2": "UNIT G-127",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853921003",
            "telephone_number": "623-882-0077",
            "fax_number": "623-882-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 N DYSART RD",
            "address_2": "UNIT G-127",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853921003",
            "telephone_number": "623-882-0077",
            "fax_number": "623-882-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAITRA",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "31741",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "31741",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Maese, NP
• Fedelia Maez, PA-C
• Jasmin Magana, RN
• Adnan Mahmood, DO
• Mai Smile Dental PC
• Subhasis Kumar Maitra, MD
• Jahneisha Major
• Taliah Major
• Andrew Emil Makar
• Gina Makdesi

• Internal Medicine Physician in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.