SANJEEV R JAIN MD
NPI 1790887578
Pediatrics in Madison, WI

NPI Status: Active since September 02, 2006

Contact Information

451 JUNCTION RD
MADISON, WI
ZIP 53717
Phone: (608) 265-7740
Fax: (608) 265-7751

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Pediatrics
Accepts Insurance
PECOS Enrolled

About SANJEEV JAIN

This page provides the complete NPI Profile along with additional information for Sanjeev Jain, a pediatrician established in Madison, Wisconsin with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1790887578 assigned on September 2006. The practitioner's primary taxonomy code is 208000000X with license number 44868 (WI). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI: 1790887578
Provider Name: SANJEEV R JAIN MD
Gender: Male
Entity Type: Individual
Location Address: 451 JUNCTION RD MADISON, WI 53717
Location Phone: (608) 265-7740
Location Fax: (608) 265-7751
Mailing Address: 7974 UW HEALTH CT MIDDLETON, WI 53562
Mailing Phone: (608) 829-5485
Is Sole Proprietor?: No
Enumeration Date: 09-02-2006
Last Update Date: 02-02-2021
Code Navigator

A pediatrician like Sanjeev Jain is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Pediatrics
Taxonomy Code: 208000000X
Type: Allopathic & Osteopathic Physicians
License No.: 44868
License State: WI
Taxonomy Description: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

Aspirus Health Plan

HMO Bronze $0 Medical Deductible - HMO
HMO Bronze 7500 - HMO
HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
HMO Gold 1500 - HMO
HMO Gold 2400 - HMO
HMO HDHP Bronze 7200 - HMO
HMO HDHP Silver 5400 - HMO
HMO Silver 5000 - HMO
HMO Silver 6600 - HMO
POS Bronze 7500 - POS

Group Health Cooperative-SCW

Partners HMO Bronze 5000 Ded/9200 MOOP - HMO
Partners HMO Bronze 7500 Ded/9200 MOOP - HMO
Partners HMO Bronze 7900 Ded/7900 MOOP HSA - HMO
Partners HMO Gold 1000 Ded/6000 MOOP with Vision - HMO
Partners HMO Gold 1500 Ded/7800 MOOP - HMO
Partners HMO Gold 2900 Ded/2900 MOOP HSA - HMO
Partners HMO Silver 4100 Ded/7500 MOOP with Vision - HMO
Partners HMO Silver 5000 Ded/8000 MOOP - HMO
Partners HMO Silver 5500 Ded/5500 MOOP HSA - HMO

HealthPartners

Robin Oak $1,000 Gold - PPO
Robin Oak $1,500 Standard Gold - PPO

Quartz

QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO

Security Health Plan

Enrich $1,500 - 25% - HMO
Enrich $3,500 - 30% - HMO
Enrich $4,100 HDHP - HMO
Enrich $5,000 - 40% - HMO
Enrich $6,200 HDHP - HMO
Enrich $7,500 - HMO
Enrich $9,200 - HMO
Enrich Protection - HMO
Premier $1,500 - 25% - HMO
Premier $3,500 - 30% - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
34306900	MEDICAID (05)	WI

Medicare Participation & PECOS Enrollment Status

Sanjeev Jain is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53717 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $82.92
Minimum New Patient Price $53.9
Maximum New Patient Price $163.24

Average New Patient Copayment $20.73
Minimum New Patient Copayment $13.47
Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $95.41
Minimum Established Patient Price $17.4
Maximum Established Patient Price $133.76

Average Established Patient Copayment $23.85
Minimum Established Patient Copayment $4.35
Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	9	0	8	8	7	5	7	8
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	18	0	16	8	14	5	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 8 + 0 + 1 + 6 + 8 + 1 + 4 + 5 + 1 + 4 + 24 = 72
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 72 = 8									8

The NPI number 1790887578 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

MRS. MELINDA KAY ROSE ARNP

Nurse Practitioner

451 JUNCTION RD
MADISON, WI
ZIP 53717

About SANJEEV JAIN

Location Map

Specialty - Primary Taxonomy

Pediatrics

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Reviews for SANJEEV R JAIN MD

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions