Individual provider Active NPI

Sanjeev R Jain, MD

  • Pediatrics Physician
  • Madison, WI
National Provider Identifier
1790887578
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
44868 Issued in WI
Practice address
451 Junction Rd
Madison, WI 53717-2656
Phone
(608) 265-7740
Fax
(608) 265-7751
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 44868 WI Primary

Addresses

Primary practice location

451 Junction Rd
Madison, WI 53717-2656

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531
Phone (608) 829-5485

Other identifiers 1

IdentifierTypeStateIssuer
34306900MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjain794780@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20080317000338 WI Practitioner - Pediatric Medicine 0143305078 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44868WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2016 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2016 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

2880 University Ave
Madison, WI 53705
Phone (608) 263-6421

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

451 Junction Rd
Madison, WI 53717
Phone (608) 263-5010

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Interoperability endpoints

  • Direct secure messaging: sjain794780@direct.uwhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1790887578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531",
            "telephone_number": "608-829-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 JUNCTION RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172656",
            "telephone_number": "608-265-7740",
            "fax_number": "608-265-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SANJEEV",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "44868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34306900",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjain794780@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "451 Junction Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537172656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.