SANJAY S. JAIN MD
NPI 1205803632
Internal Medicine - Pulmonary Disease in Fort Wayne, IN

Active since March 03, 2006PECOS EnrolledAccepts Medicare Assignment
87.95/100
CMS Quality Rating
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804(260) 432-2297(260) 434-6481 Get Directions Write a Review

NPPES record last updated: September 29, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 29, 2020, Dec 22, 2016 (2 updates tracked since 2016).

About Sanjay S. Jain Md NPPES

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

SANJAY S. JAIN MD (NPI 1205803632) is an individual pulmonary disease provider in Fort Wayne, Indiana, licensed in Indiana (01060078A) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Lutheran Hospital Of Indiana, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1205803632
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameSANJAY S. JAINCredential: MD
Location Address7916 W JEFFERSON BLVDFort Wayne, IN 46804-4140
Mailing Address6920 Pointe Inverness Way Ste 200, Medpartners, Attn: Barb CopelandFort Wayne, IN 46804-7934 · (260) 479-3514 · Fax (260) 479-3520
Fax(260) 434-6481
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateMarch 3, 2006
Last NPPES UpdateSeptember 29, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2020
NPI 1205803632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in IN · 01060078A
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.
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 01060078A (IN)
7916 W JEFFERSON BLVD, Fort Wayne, IN 46804

Other Identifiers 4

Medicaid2538016OH
Medicaid200506290IN
OtherP00191330Railroad
Other000000354843IN · Anthem

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

Sanjay S. Jain Md 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 ID6204727548
PECOS Enrollment IDI20050301000307, I20071005000466
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 18

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.
236 services118 patients
Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation G0398
A home sleep study test with a type II portable monitor is a non-invasive procedure done at home to monitor your sleep. It records data like brain waves, eye movements, muscle activity, heart rate, breathing, and oxygen levels. This helps identify sleep disorders.
94 services94 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.
84 services84 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
83 services83 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.
74 services74 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
67 services40 patients

Hospital Affiliations CMS Care Compare 5

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

Lutheran Hospital Of Indiana

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number150017
Location7950 W Jefferson BlvdFort Wayne, IN 46804 · Allen County
Emergency services Birthing friendly

Bluffton Regional Medical Center

Acute Care Hospitals · Bluffton, IN
4/5 CMS rating
OwnershipProprietary
CMS Certification Number150075
Location303 S Main StBluffton, IN 46714 · Wells County
Emergency services Birthing friendly

Kosciusko Community Hospital

Acute Care Hospitals · Warsaw, IN
2/5 CMS rating
OwnershipProprietary
CMS Certification Number150133
Location2101 E Dubois DrWarsaw, IN 46580 · Kosciusko County
Emergency services Birthing friendly

Dupont Hospital LLC

Acute Care Hospitals · Fort Wayne, IN
4/5 CMS rating
OwnershipProprietary
CMS Certification Number150150
Location2520 E Dupont RdFort Wayne, IN 46825 · Allen County
Emergency services Birthing friendly

Cameron Memorial Community Hospital Inc

Critical Access Hospitals · Angola, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151315
Location416 E Maumee StAngola, IN 46703 · Steuben County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46804 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

87.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.04
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 26

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
15 suppliers216 claims216 services$38.41 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
15 suppliers165 claims165 services$99.81 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
15 suppliers161 claims420 services$37.72 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
9 suppliers55 claims303 services$20.00 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
9 suppliers43 claims224 services$17.17 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
13 suppliers108 claims108 services$63.08 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 20

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

Nurse Practitioner (Family)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Internal Medicine (Interventional Cardiology)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Physician Assistant
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Internal Medicine (Clinical Cardiac Electrophysiology)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Internal Medicine
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Internal Medicine (Interventional Cardiology)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Physician Assistant
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Internal Medicine (Cardiovascular Disease)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

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 Sanjay Jain's NPI number?

The NPI number for Sanjay Jain is 1205803632. It was assigned to this individual provider in the NPPES registry on March 3, 2006.

Where is Sanjay Jain located?

Sanjay Jain practices at 7916 W Jefferson Blvd, Fort Wayne, IN 46804. The listed phone number is (260) 432-2297.

What is Sanjay Jain's specialty?

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

Is Sanjay Jain enrolled in Medicare?

Yes. Sanjay 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 Sanjay Jain accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Sanjay 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 Sanjay Jain affiliated with any hospitals?

According to CMS data, Sanjay Jain is affiliated with Lutheran Hospital Of Indiana, Bluffton Regional Medical Center, Kosciusko Community Hospital, Dupont Hospital LLC and Cameron Memorial Community Hospital Inc.

When was this NPI record last updated?

The NPPES record for Sanjay Jain was last updated on September 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.