NPIMap

Individual provider Active NPI

Sharmini Jayamaha, M.D.

  • Nephrology Physician
  • Riverhead, NY
National Provider Identifier
1912942558
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
212805 Issued in NY
Practice address
632 Roanoke Avenue
East End Nephrology, P.C.
Riverhead, NY 11901
Phone
(631) 208-8270
Fax
(631) 208-8271
NPI assigned
Jun 18, 2006
Last updated
Nov 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 212805 NY Primary

Addresses

Primary practice location

632 Roanoke Avenue
East End Nephrology, P.C.
Riverhead, NY 11901

Mailing address

222 Manor PL
Suite 102
Greenport, NY 11944-1261
Phone (631) 477-1755

Other identifiers 1

IdentifierTypeStateIssuer
02360956MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006000349 NY Practitioner - NephrologyPractitioner - Internal Medicine 8527027531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 Manor Place
Suite 102
Greenport, NY 11944-1223
Phone (631) 477-1755

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
20.1 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
67.02

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East End Nephrology, PC CurrentSince Jul 12, 2004 Accepting new patients
Executive Medical Imaging Services, PLLC PastSince Jul 12, 2004 Accepting new patients

Locations

222 Manor Pl
Ste 102
Greenport, NY 11944
Phone (631) 477-1755

632 Roanoke Ave
Riverhead, NY 11901
Phone (631) 208-8270

Interoperability endpoints

  • Direct secure messaging: sjayamaha66907@northwell.direct-ci.com

Organizations & group practices 2

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 8

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1912942558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MANOR PL",
            "address_2": "SUITE 102",
            "city": "GREENPORT",
            "state": "NY",
            "postal_code": "119441261",
            "telephone_number": "631-477-1755",
            "fax_number": "631-477-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 ROANOKE AVENUE",
            "address_2": "EAST END NEPHROLOGY, P.C.",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "11901",
            "telephone_number": "631-208-8270",
            "fax_number": "631-208-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYAMAHA",
        "first_name": "SHARMINI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "212805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02360956",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.