Individual provider Active NPI

Sanjay Jain

  • Diagnostic Radiology Physician
  • Houston, TX
National Provider Identifier
1790050052
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
Q8080 Issued in TX
Practice address
6431 Fannin
Suite MSB 2.116
Houston, TX 77030-5389
Phone
(713) 500-7640
Fax
(713) 500-7647
NPI assigned
Mar 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Q8080 TX Primary

Addresses

Primary practice location

6431 Fannin
Suite MSB 2.116
Houston, TX 77030-5389

Mailing address

6431 Fannin
Suite MSB 2.116
Houston, TX 77030-5389
Phone (713) 500-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170803002719 TX Practitioner - Diagnostic Radiology 5991076333 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at Houston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Radiology AssociatedGroup PAC ID 8022092451, 107 clinicians

Practice addresses (Care Compare)

6565 Fannin St
Houston, TX 77030-2703
Phone (281) 206-9020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.75 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q8080TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Diagnostic Radiology CurrentSince Sep 1, 2017 Accepting new patients
Houston Radiology Associated Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
Ut Physicians CurrentSince Sep 1, 2017 Accepting new patients
Utmb Faculty Group Practice Diagnostic Radiology CurrentSince Mar 2, 2018 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

18500 Katy Fwy
Houston, TX 77094
Phone (281) 206-9020

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6431 Fannin St
Ste Msb
Houston, TX 77030
Phone (713) 500-5800

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1790050052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN",
            "address_2": "SUITE MSB 2.116",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305389",
            "telephone_number": "713-500-7640",
            "fax_number": "713-500-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN",
            "address_2": "SUITE MSB 2.116",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305389",
            "telephone_number": "713-500-7640",
            "fax_number": "713-500-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SANJAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-19",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "Q8080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.