Individual provider Active NPI

Jaya Madhav, MD

  • Internal Medicine Physician
  • Vancouver, WA
National Provider Identifier
1770970048
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61082233 Issued in WA
Practice address
700 NE 87TH Ave Ste 220
Vancouver, WA 98664-4896
Phone
(360) 882-2778
NPI assigned
Apr 23, 2015
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61082233 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave Ste 220
Vancouver, WA 98664-4896

Mailing address

PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778

Other practice location 1

4212 NE Broadway
Portland, OR 97213
Phone (503) 249-8787

Other identifiers 1

IdentifierTypeStateIssuer
2165746MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, IN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20181108000820 OR Practitioner - Internal Medicine 5193030138 Reassigns benefits to 1 organization
I20201211001445 WA Practitioner - Internal Medicine 5193030138 Reassigns benefits to 1 organization
I20230513000076 IN Practitioner - Internal Medicine 5193030138 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners PC CurrentSince Mar 20, 2023 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jan 11, 2021 Accepting new patients
Openloop Healthcare Partners California PC CurrentSince Mar 20, 2023 Accepting new patients
Openloop Healthcare Partners California PC CurrentSince Mar 20, 2023 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jan 11, 2021 Accepting new patients
The Vancouver Clinic Inc PS Internal Medicine CurrentSince Jan 17, 2021 Accepting new patients
Cloud Health Medical Group of California, P.C. Internal Medicine Past Accepting new patients
Cloud Health Medical Group, P.a. Internal Medicine Past Accepting new patients

Locations

2121 E Coast Hwy
Ste 270
Corona del Mar, CA 92625
Phone (949) 694-4937

818 W 7th St
Los Angeles, CA 90017
Phone (949) 694-4937

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

334 N Senate Ave
Indianapolis, IN 46204
Phone (224) 760-7322

100 E Campus View Blvd
Ste 250
Columbus, OH 43235
Phone (267) 817-8902

4400 Easton Cmns
Ste 125
Columbus, OH 43219
Phone (855) 679-2366

780 Commercial St SE
Ste 100
Salem, OR 97301
Phone (469) 466-7037

10260 SW Greenburg Rd
Fl 4
Tigard, OR 97223
Phone (503) 405-9338

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

700 NE 87th Ave
Ste 220
Vancouver, WA 98664
Phone (360) 397-3462

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1770970048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE STE 220",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4212 NE Broadway",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97213",
            "country_code": "US",
            "telephone_number": "503-249-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADHAV",
        "first_name": "JAYA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61082233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2165746",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.