NPIMap

Individual provider Active NPI

Jaya B Ganesh, M.D.

  • Clinical Genetics (M.D.) Physician
  • New York, NY
National Provider Identifier
1740202159
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
MD417029 Issued in PA
Practice address
Genetics & Genomic Sciences
1 Gustave Levy L. Place #1497
New York, NY 10029-6500
Phone
(212) 241-6947
Fax
(212) 860-3316
NPI assigned
Jul 24, 2006
Last updated
Mar 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Biochemical Genetics Physician 207SG0202X MD417029 PA
Pediatrics Physician 208000000X MD417029 PA
Clinical Genetics (M.D.) Physician 207SG0201X MD417029 PA Primary

Addresses

Primary practice location

Genetics & Genomic Sciences
1 Gustave Levy L. Place #1497
New York, NY 10029-6500

Mailing address

1 Gustave L Levy PL # 1497
New York, NY 10029-6504
Phone (212) 241-6947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141217002085 NJ Practitioner - Pediatric MedicinePractitioner - Medical Genetics and Genomics 2466353438 Reassigns benefits to 1 organization
I20190206001145 NY Practitioner - Pediatric Medicine 2466353438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1428 Madison Ave
New York, NY 10029-6508
Phone (212) 241-6947

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Pediatric Specialists, PC Pediatrics CurrentSince Oct 8, 2014 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 15, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 15, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

1428 Madison Ave
New York, NY 10029
Phone (212) 241-6947

1428 Madison Ave
Fl 1
New York, NY 10029
Phone (212) 241-6947

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1740202159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1497",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-241-6947",
            "fax_number": "212-860-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GENETICS & GENOMIC SCIENCES",
            "address_2": "1 GUSTAVE LEVY L. PLACE #1497",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-6947",
            "fax_number": "212-860-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANESH",
        "first_name": "JAYA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "PA",
            "license": "MD417029",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD417029",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "PA",
            "license": "MD417029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.