Jayanthi Rachakonda Smucker, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036098627 Issued in IL

Practice address

415 E Madison St
South Bend, IN 46617-2322

Phone

(574) 533-1234

Fax

(574) 533-1234

NPI assigned

Aug 31, 2006

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

Other identifiers 4

Other names 1

• Dr. Jayanthi Rachakonda Sarma Other name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Psychiatry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oaklawn Psychiatric Center IncGroup PAC ID 6002801065, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Oaklawn Psychiatric Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elkhart, IN
  • NPI 1598847212
  Medicare reassignment Care Compare group NPD
• Oaklawn Psychiatric Center, Inc.

  • Psychiatric Hospital
  • Goshen, IN
  • NPI 1467407395
  NPD
• Psychological Associates of Central Illinois LTD

  • Psychiatry Physician
  • Springfield, IL
  • NPI 1376698050
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1972615029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465270809",
            "telephone_number": "574-533-1234",
            "fax_number": "574-533-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E MADISON ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172322",
            "telephone_number": "574-533-1234",
            "fax_number": "574-533-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMUCKER",
        "first_name": "JAYANTHI",
        "middle_name": "RACHAKONDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036098627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00159341",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098627",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "540733",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "093984",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYANTHI",
            "last_name": "SARMA",
            "middle_name": "RACHAKONDA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Moriah Smith
• Sarah Smith
• Stephen M. Smith, M.D.
• Sydney Smith, RBT
• Timothy S Smith, M.D.
• Alan Snell, MD
• Mark V Snell, LCSW
• Bridget L Sniadecki, PTA
• Susan Snider, MSN, FNP-BC
• David Carl Snodgrass, RPH

• Psychiatry Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.