JAI K MEDIRATTA DDS
NPI 1225618390
Oral & Maxillofacial Surgery in Rochester, MN

Q: What is Jai Mediratta's NPI number?

The NPI number for Jai Mediratta is 1225618390. It was assigned to this individual provider in the NPPES registry on April 12, 2021.

Q: What is Jai Mediratta's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Q: When was this NPI record last updated?

The NPPES record for Jai Mediratta was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since April 12, 2021PECOS Enrolled

200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511(507) 284-2511 Get Directions Write a Review

NPPES record last updated: December 4, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 4, 2025, Nov 18, 2025, Jul 9, 2021 and 1 more (4 updates tracked since 2021).

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About Jai K Mediratta Dds NPPES

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

JAI K MEDIRATTA DDS (NPI 1225618390) is an individual oral & maxillofacial surgery provider in Rochester, Minnesota, licensed in Minnesota (80453) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225618390

Entity TypeIndividualMale

Primary Taxonomy204E00000X

Provider Legal NameJAI K MEDIRATTACredential: DDS

Location Address200 1ST ST SWRochester, MN 55905-0002

Mailing AddressPo Box 860912Minneapolis, MN 55486-0912 · (507) 284-2511

Phone(507) 284-2511

Fax(507) 284-2511

Sole ProprietorNo

Enumeration DateApril 12, 2021

Last NPPES UpdateDecember 4, 20254 updates tracked since enumeration

NPPES CertifiedDecember 4, 2025

✔ NPI 1225618390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code204E00000X

License✔ Licensed in MN · 80453

Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License D14574 (MN)

200 1ST ST SW, Rochester, MN 55905

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Combined Life.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jai K Mediratta Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Jai Mediratta reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mayo Clinic

10 mi

Infectious Disease

200 1ST ST SW
Rochester, MN 55905

Reassigned Medicare billing, Minnesota enrollment
6,534 clinicians in this Medicare group

NPI 1114343860 (507) 284-2511

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

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.

EMILY LEASURE MD

Internal Medicine