NPIMap

Organization Active NPI

JDJ Medical LLC

  • Psychiatry Physician
  • Newark, DE
National Provider Identifier
1699200873
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C1-0011584 Issued in DE
Legal business name
JDJ MEDICAL LLC
Practice address
314 E Main St
Suite 403
Newark, DE 19711-7128
Phone
(302) 983-2646
Fax
(302) 369-3093
NPI assigned
Apr 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
Jeet Joshi, MDNPI 1356634901
Title
Authorized Official
Phone
(302) 983-2646

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X C1-0011584 DE Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

314 E Main St
Suite 403
Newark, DE 19711-7128

Mailing address

314 E Main St
Suite 403
Newark, DE 19711-7128
Phone (302) 983-2646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170623000110 DE Part B Supplier - Clinic/Group Practice 4385912963 Receives reassigned benefits from 4 practitioners
Practice locations: Newark, DE; Wilmington, DE

National Provider Directory

National Provider Directory

Locations

314 E Main St
Ste 403
Newark, DE 19711
Phone (302) 369-3533

5509 Kirkwood Hwy
Unit 6
Wilmington, DE 19808
Phone (302) 842-2166

Practitioners & affiliated clinicians

Practitioners 4

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": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1699200873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E MAIN ST",
            "address_2": "SUITE 403",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117128",
            "telephone_number": "302-983-2646",
            "fax_number": "302-369-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E MAIN ST",
            "address_2": "SUITE 403",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117128",
            "telephone_number": "302-983-2646",
            "fax_number": "302-369-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JDJ MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "JOSHI",
        "authorized_official_first_name": "JEET",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "302-983-2646",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C1-0011584",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.