Active NPI
Kavisha Jain
- Internal Medicine Physician
- New Haven, CT
National Provider Identifier
1962039644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 75557
- Practice address
- 20 York St
New Haven, CT 06510-3220 - Phone
- (203) 785-3207
- NPI assigned
- Mar 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 75557 | CT | Primary |
Addresses
Primary practice location
20 York St
New Haven, CT 06510-3220
Mailing address
PO Box 689
Cataula, GA 31804-0689
Phone (404) 514-5675
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75557 | CT | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1962039644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 689",
"city": "CATAULA",
"state": "GA",
"postal_code": "318040689",
"telephone_number": "404-514-5675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 YORK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065103220",
"telephone_number": "203-785-3207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "KAVISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-24",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "75557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.