Samiksha Fouzdar Jain, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

31600 Issued in NE

Practice address

3902 Leavenworth St
Omaha, NE 68105-1119

Phone

(402) 559-2020

NPI assigned

Aug 22, 2017

Last updated

Aug 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE, TX2 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

Specialty

Ophthalmology

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment NPD
• Total Care PLLC

  • Ophthalmology Physician
  • El Paso, TX
  • NPI 1487285656
  Medicare reassignment NPD

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1922524826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 LEAVENWORTH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051119",
            "telephone_number": "402-559-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUZDAR JAIN",
        "first_name": "SAMIKSHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NE",
            "license": "31600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jutta L Fournier, LMHP
• Emily Kay Foutch
• Shelley Kay Foutch, CRNA
• Amanda Fouts
• Dena Fouts
• Andreana Fowler
• Bobbie Jean Fowler, DDS
• Christine Kay Fowler, M.S CCC SLP
• Doris Fowler
• Jake Fowler, MD

• Ophthalmology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Ophthalmology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.