Individual provider Active NPI

Beth Ann Jayne, MD

  • Internal Medicine Physician
  • Watertown, NY
National Provider Identifier
1871607184
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
307832 Issued in NY
Practice address
238 Arsenal St
Watertown, NY 13601-2504
Phone
(315) 782-9450
Fax
(315) 782-2643
NPI assigned
Aug 17, 2006
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 307832 NY Primary
Pediatrics Physician 208000000X 307832 NY

Addresses

Primary practice location

238 Arsenal St
Watertown, NY 13601-2504

Mailing address

238 Arsenal St
Watertown, NY 13601-2504
Phone (315) 782-9450

Other identifiers 1

IdentifierTypeStateIssuer
891356YMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20040426001273 NC Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2567459316 Reassigns benefits to 2 organizations
I20210301000107 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2567459316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
State University of Ny Upstate Medical University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

238 Arsenal St
Watertown, NY 13601-2504
Phone (315) 782-9450

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
307832NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Internal Medicine CurrentSince Apr 1, 2004 Accepting new patients
North Country Family Health Center, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 1, 2004 Accepting new patients
North Country Family Health Center, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Novant Medical Group Inc CurrentSince Mar 6, 2011 Accepting new patients
Novant Health Medical Group, LLC Internal Medicine Past Accepting new patients

Locations

14330 Oakhill Park Ln
Ste 115
Huntersville, NC 28078
Phone (704) 316-1265

16525 Holly Crest Ln
Ste 150
Huntersville, NC 28078
Phone (704) 384-1725

17220 Northcross Dr
Ste 110
Huntersville, NC 28078
Phone (704) 384-8720

1995 Wellness Blvd
Ste 110
Monroe, NC 28110
Phone (704) 316-3030

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

13180 US Route 11
Adams Center, NY 13606
Phone (315) 583-5200

5402 Dayan St
Ste 100
Lowville, NY 13367
Phone (315) 376-4600

423 N Main St
Mannsville, NY 13661

1220 Coffeen St
Watertown, NY 13601
Phone (315) 786-1042

1237 Washington St
Watertown, NY 13601
Phone (315) 785-3700

1335 Washington St
Watertown, NY 13601
Phone (315) 785-3700

1351 Washington St
Watertown, NY 13601
Phone (315) 785-3700

171 E Hoard St
Watertown, NY 13601
Phone (315) 785-3750

238 Arsenal St
Watertown, NY 13601
Phone (315) 782-9450

Interoperability endpoints

  • Direct secure messaging: beth.jayne.1@21901.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1871607184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012504",
            "telephone_number": "315-782-9450",
            "fax_number": "315-782-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012504",
            "telephone_number": "315-782-9450",
            "fax_number": "315-782-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYNE",
        "first_name": "BETH ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "307832",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "307832",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891356Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.