PRIYANKA JAIN
NPI 1124405899
Internal Medicine - Pulmonary Disease in Oregon, OH

Active since May 01, 2015PECOS EnrolledAccepts Medicare Assignment
61.57/100
CMS Quality Rating
4330 NAVARRE AVE STE 101, OREGON, OH 43616(419) 693-4151(419) 693-8137 Get Directions Write a Review

NPPES record last updated: January 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 15, 2026, Jul 3, 2024 (2 updates tracked since 2024).

About Priyanka Jain NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIYANKA JAIN (NPI 1124405899) is an individual pulmonary disease provider in Oregon, Ohio, licensed in Ohio (35.142380) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS, is affiliated with Promedica Monroe Regional Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1124405899
Entity TypeIndividualFemale
Primary Taxonomy207RP1001X
Provider Legal NamePRIYANKA JAIN
Location Address4330 NAVARRE AVE STE 101Oregon, OH 43616-3587
Mailing Address4330 Navarre Ave Ste 101Oregon, OH 43616-3587 · (419) 693-4151 · Fax (419) 693-8137
Fax(419) 693-8137
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 1, 2015
Last NPPES UpdateJanuary 15, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2026
NPI 1124405899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in OH · 35.142380
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
4330 NAVARRE AVE STE 101, Oregon, OH 43616

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Priyanka Jain is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062768435
PECOS Enrollment IDI20220221000485, I20251121002020
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
349 services156 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
294 services174 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
152 services115 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
143 services142 patients
Evaluation of use of breathing device 94664
The evaluation of a breathing device involves checking how effectively you're using it to manage your respiratory condition. It assesses the device's fit, your comfort, and your technique to ensure optimal results.
142 services141 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
141 services140 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Promedica Monroe Regional Hospital

Acute Care Hospitals · Monroe, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230099
Location718 N Macomb StMonroe, MI 48162 · Monroe County
Emergency services Birthing friendly

Miami Valley Hospital

Acute Care Hospitals · Dayton, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360051
LocationOne Wyoming StreetDayton, OH 45409 · Montgomery County
Emergency services Birthing friendly

Promedica Toledo Hospital

Acute Care Hospitals · Toledo, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360068
Location2142 North Cove BoulevardToledo, OH 43606 · Lucas County
Emergency services Birthing friendly

Mercy St Vincent Medical Center

Acute Care Hospitals · Toledo, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360112
Location2213 Cherry StreetToledo, OH 43608 · Lucas County
Emergency services Birthing friendly

Bay Park Community Hospital

Acute Care Hospitals · Oregon, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360259
Location2801 Bay Park DriveOregon, OH 43616 · Lucas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43616 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

61.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.18
Promoting Interoperability0
Improvement Activities40
Cost66.38

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
8 suppliers14 claims14 services$77.78 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers13 claims13 services$47.67 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
8 suppliers21 claims21 services$15.83 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
5 suppliers16 claims16 services$11.23 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
10 suppliers36 claims129 services$1.74 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers29 claims29 services$15.74 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
4330 NAVARRE AVE STE 101
OREGON, OH 43616

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Priyanka Jain's NPI number?

The NPI number for Priyanka Jain is 1124405899. It was assigned to this individual provider in the NPPES registry on May 1, 2015.

Where is Priyanka Jain located?

Priyanka Jain practices at 4330 Navarre Ave Ste 101, Oregon, OH 43616. The listed phone number is (419) 693-4151.

What is Priyanka Jain's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Priyanka Jain enrolled in Medicare?

Yes. Priyanka Jain is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Priyanka Jain accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Molina Healthcare list Priyanka Jain as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Priyanka Jain affiliated with any hospitals?

According to CMS data, Priyanka Jain is affiliated with Promedica Monroe Regional Hospital, Miami Valley Hospital, Promedica Toledo Hospital, Mercy St Vincent Medical Center and Bay Park Community Hospital.

When was this NPI record last updated?

The NPPES record for Priyanka Jain was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.