Active NPI
Sushil K. Jain, MD
- Gastroenterology Physician
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 01051909A
- Practice address
- 7900 W Jefferson Blvd
Suite 201
Fort Wayne, IN 46804-4128 - Phone
- (260) 432-2297
- Fax
- (260) 969-7266
- NPI assigned
- Mar 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 01051909A | IN | Primary |
Addresses
Primary practice location
7900 W Jefferson Blvd
Suite 201
Fort Wayne, IN 46804-4128
Mailing address
6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2187860 | Medicaid | OH | |
| 000000110957 | Other | IN | ANTHEM |
| 200271250 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sushil.jain@lutheranhealthnetwork.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2510 E Dupont Rd
Fort Wayne, IN 46825-1603
2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076
2520 E Dupont Rd
Dupont Hospital
Fort Wayne, IN 46825-1675
Phone (260) 432-2297
7900 W Jefferson Blvd
Fort Wayne, IN 46804-4128
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 432-2297
7938 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 436-8583
7950 W Jefferson Blvd
Lutheran Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-7001
7952 W Jefferson Blvd
The Orthopedic Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-2999
7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-2836
7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-6105
7988 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 969-7280
Hospital & facility affiliations
- Lutheran Hospital of Indiana
- Dupont Hospital LLC
- Kosciusko Community Hospital
- Parkview Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.99 of 100
- Quality
- 77.41
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 152 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 187 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Medical Group LLC | Current | Accepting new patients | |
| Lutheran Medical Group LLC | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
2510 E DuPont Rd
Ste 206
Fort Wayne, IN 46825
Phone (260) 416-5954
3534 Brooklyn Ave
Fort Wayne, IN 46809
Phone (219) 478-5180
7900 W Jefferson Blvd
Ste 201
Fort Wayne, IN 46804
Phone (260) 969-7100
6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514
7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298
2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Fort Wayne, IN
- NPI 1164662805
-
- Durable Medical Equipment & Medical Supplies
- Fort Wayne, IN
- NPI 1710275664
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1538110556
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1306897335
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1366407603
-
- General Acute Care Hospital
- Warsaw, IN
- NPI 1164475711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601337600000",
"number": "1649247057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6920 POINTE INVERNESS WAY STE 200",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047934",
"telephone_number": "260-479-3514",
"fax_number": "260-479-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7900 W JEFFERSON BLVD",
"address_2": "SUITE 201",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044128",
"telephone_number": "260-432-2297",
"fax_number": "260-969-7266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "SUSHIL",
"middle_name": "K.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-03",
"last_updated": "2020-09-29",
"certification_date": "2020-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IN",
"license": "01051909A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2187860",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000110957",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200271250",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sushil.jain@lutheranhealthnetwork.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "AMR direct address",
"address_1": "7900 W Jefferson Blvd",
"address_2": "Suite 201",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468044128",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.