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

Q: 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.

Q: What is Sanjay Jain's specialty?

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

Q: 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 6 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.

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: October 25, 2026.

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

On this page

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

Phone(260) 432-2297

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

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Other Identifiers 4

Medicaid2538016OH

Medicaid200506290IN

OtherP00191330Railroad

Other000000354843IN · Anthem

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Sanjay Jain reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lutheran Medical Group LLC

Same address

Cardiovascular Disease

7916 W JEFFERSON BLVD
Fort Wayne, IN 46804

Reassigned Medicare billing, Indiana and Ohio enrollments
301 clinicians in this Medicare group

NPI 1164662805 (260) 432-2297

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

65 services47 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

46 services42 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.

44 services35 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

44 services44 patients

Test to determine lung volumes using sensors 94726

43 services43 patients

Test to examine how well the lungs exchange gases 94729

43 services43 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.

33 services29 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

32 services31 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

27 services27 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

23 services23 patients

Test to measure expiratory airflow and volume 94010

21 services21 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

17 services14 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

Quality

74.04

Promoting Interoperability

100

Improvement Activities

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

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

17 suppliers173 claims173 services$21.04 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

13 suppliers47 claims47 services$18.64 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

18 suppliers239 claims1,242 services$2.44 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

8 suppliers32 claims32 services$7.52 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

16 suppliers112 claims112 services$12.75 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 suppliers46 claims49 services$18.88 avg. paid by Medicare

Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) E0465

DME-Other DME · category DE005N

1 supplier12 claims12 services$784.18 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

2 suppliers26 claims26 services$778.38 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

4 suppliers32 claims33 services$93.13 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0471

DME-Other DME · category DE001N

4 suppliers24 claims24 services$260.71 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

8 suppliers30 claims30 services$170.26 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

7 suppliers65 claims66 services$14.05 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers22 claims22 services$7.93 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

14 suppliers290 claims290 services$43.75 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

9 suppliers120 claims122 services$102.21 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

4 suppliers22 claims22 services$33.75 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

3 suppliers19 claims4,961 services$0.03 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

3 suppliers16 claims1,320 services$0.74 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

2 suppliers19 claims19 services$38.14 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

4 suppliers27 claims27 services$24.12 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.

LISA R. STANLEY NP

Nurse Practitioner (Family)

7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Allen County (260) 434-6322

STEPHEN K. REED MD

Internal Medicine (Interventional Cardiology)

7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Allen County (260) 432-2297

ERIC M. GODDARD PA-C

Physician Assistant

7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Allen County (260) 434-6322

JASON MICHAEL RODRIGUEZ MD

Internal Medicine (Clinical Cardiac Electrophysiology)

7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Allen County (260) 432-2297

JEANNE M. ROWE M.D.

Internal Medicine

7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Allen County (260) 432-2297

DR. MUZAMMIL HANIF MUSANI M.D

Internal Medicine (Interventional Cardiology)

7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Allen County (260) 432-2297

ANN M. GRUBB PA

Physician Assistant

7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Allen County (260) 432-2297

DR. MADHU G. JYOTHINAGARAM MD

Internal Medicine (Cardiovascular Disease)

7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Allen County (260) 432-2297

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.

Which organization bills Medicare for Sanjay Jain's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sanjay Jain reassigns Medicare benefits to Lutheran Medical Group LLC (Fort Wayne, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sanjay Jain's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sanjay Jain accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield 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 6 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.