Individual provider Active NPI

Deepika Jain, M.D.

  • Internal Medicine Physician
  • Millburn, NJ
National Provider Identifier
1750551875
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA09635900 Issued in NJ
Practice address
33 Bleeker St Ste 104
Millburn, NJ 07041-1460
Phone
(973) 379-9051
Fax
(973) 379-8828
NPI assigned
Mar 4, 2008
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2010024518 MO
Internal Medicine Physician 207R00000X 125052432 IL
Internal Medicine Physician 207R00000X 25MA09635900 NJ Primary

Addresses

Primary practice location

33 Bleeker St Ste 104
Millburn, NJ 07041-1460

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Other practice location 1

11 Overlook Rd Ste 100
Summit, NJ 07901-3580
Phone (973) 377-2400

Other identifiers 1

IdentifierTypeStateIssuer
0479730MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address deepika.jain.2@14360.direct.athenahealth.com

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150630002084 NJ Practitioner - NephrologyPractitioner - Internal Medicine 9032235890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

1139 Spruce Dr
Mountainside, NJ 07092-2221
Phone (877) 588-5688

131 S 31St St
Kenilworth, NJ 07033-1331
Phone (908) 241-0453

879 Rahway Ave
Union, NJ 07083-6633
Phone (908) 964-5606

91 -101 Hartford St
Newark, NJ 07103-2833
Phone (973) 624-7100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125052432ILMDInternal Medicine Physician
2010024518MOMDInternal Medicine Physician
25MA09635900NJMDInternal Medicine Physician
25MA09636900NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Internal Medicine CurrentSince Dec 4, 2023 Accepting new patients
Ijkg Opco LLC Current Accepting new patients
Medical Diagnostic Associates, PA Internal Medicine PastSince Aug 1, 2017 Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

11 Overlook Rd
Ste 100
Summit, NJ 07901
Phone (908) 273-1493

Interoperability endpoints

  • Direct secure messaging: deepika.jain@direct.bayonnemedicalcenter.md
  • Direct secure messaging: djain323615@ahs.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1750551875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 BLEEKER ST STE 104",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411460",
            "telephone_number": "973-379-9051",
            "fax_number": "973-379-8828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Overlook Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079013580",
            "country_code": "US",
            "telephone_number": "973-377-2400",
            "fax_number": "973-377-4117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "DEEPIKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2010024518",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125052432",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09635900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0479730",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deepika.jain.2@14360.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "26 Greenville Ave",
            "address_2": "suite 1",
            "city": "Jersey City",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "073052608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

Verify at the official NPI Registry.