Individual provider Active NPI

Bharti Jain, M.D.

  • Surgery Physician
  • San Bernardino, CA
National Provider Identifier
1992728992
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C42548 Issued in CA
Practice address
1800 Medical Center Dr
Suite 200
San Bernardino, CA 92411-1218
Phone
(909) 887-3432
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C42548 CA Primary

Addresses

Primary practice location

1800 Medical Center Dr
Suite 200
San Bernardino, CA 92411-1218

Mailing address

1800 Medical Center Dr
Suite 200
San Bernardino, CA 92411-1218
Phone (909) 887-3432

Other identifiers 1

IdentifierTypeStateIssuer
00C425480MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20100415000438 CA Practitioner - General SurgeryPractitioner - Peripheral Vascular DiseasePractitioner - Vascular Surgery 0244319788 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42548CAMDPediatric Dentist
C42548CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince May 23, 2007 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince May 23, 2007 Accepting new patients
San Bernardino Medical Group Inc Past Accepting new patients
Dignity Health Medical Foundation PastSince Oct 1, 2002 Accepting new patients

Locations

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1992728992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER DR",
            "address_2": "SUITE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111218",
            "telephone_number": "909-887-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER DR",
            "address_2": "SUITE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111218",
            "telephone_number": "909-887-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "BHARTI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C42548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C425480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.