NPIMap

Organization Active NPI

Dr Aditya Jain MD Inc

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1629405618
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DR ADITYA JAIN MD INC
Doing business as
EAST BAY CARDIOVASCULAR & MEDICAL SPECIALIST
Practice address
1532 150TH Ave
San Leandro, CA 94578
Phone
(510) 351-6363
Fax
(510) 278-3757
NPI assigned
Oct 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. Aditya Jain, M.D.NPI 1821102641
Title
Ceo
Phone
(510) 351-6363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X A54174 CA
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X

Addresses

Primary practice location

1532 150TH Ave
San Leandro, CA 94578

Mailing address

1532 150TH Ave
San Leandro, CA 94578-1823
Phone (510) 351-6363

Other names 2

  • EAST BAY CARDIOVASCULAR & MEDICAL SPECIALIST Doing business as
  • ADITYA JAIN MD INC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140226000136 CA Part B Supplier - Clinic/Group Practice 4183854821 Receives reassigned benefits from 9 practitioners
Practice locations: Castro Valley, CA; San Leandro, CA; Fremont, CA; Hayward, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2089430Dr. Aditya Jain MD Inc1532 150TH Ave, San Leandro, CA 94578Certificate of waiverDec 29, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1629405618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 150TH AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781823",
            "telephone_number": "510-351-6363",
            "fax_number": "510-278-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 150TH AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-351-6363",
            "fax_number": "510-278-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ADITYA JAIN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-04",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "ADITYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-351-6363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A54174",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST BAY CARDIOVASCULAR & MEDICAL SPECIALIST",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ADITYA JAIN MD INC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ADITYA JAIN MD INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.