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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

JAYA MANJUNATH
NPI 1871394858
Student in an Organized Health Care Education/Training Program in Providence, RI

Active since March 24, 2025PECOS Enrolled
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-7959 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jaya Manjunath NPPES

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

JAYA MANJUNATH (NPI 1871394858) is an individual student in an organized health care education/training program in Providence, Rhode Island and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871394858
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJAYA MANJUNATH
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address110 Lockwood StProvidence, RI 02903-4801
Phone(401) 444-7959
Sole ProprietorNo
Enumeration DateMarch 24, 2025
Last NPPES UpdateJuly 1, 2026
NPPES CertifiedJuly 1, 2026
✔ NPI 1871394858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

593 EDDY ST, Providence, RI 02903
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaya Manjunath 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.

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.

DR. CHANDAN LAKHIANI MD
Pediatrics
593 EDDY ST, HASBRO LL
PROVIDENCE, RI 02903
Providence County (401) 444-4691
RACHEL ALLISON ALTURA MD
Pediatrics (Pediatric Hematology-Oncology)
593 EDDY ST, HASBRO LL
PROVIDENCE, RI 02903
Providence County (401) 444-5241
MOHAMMED FAIZAN M.D.
Pediatrics (Pediatric Nephrology)
593 EDDY ST, HASBRO 122
PROVIDENCE, RI 02903
Providence County (401) 444-6195
ZHANHONG MI CNP
Nurse Practitioner
593 EDDY ST, APC 456
PROVIDENCE, RI 02903
Providence County (401) 444-5545
KEITH B SUNDERLIN PAC
Physician Assistant
593 EDDY ST, APC 4
PROVIDENCE, RI 02903
Providence County (401) 444-4000
DR. MARK E. MATTINGLY M.D.
Internal Medicine
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-3985
MS. JO-ANN BERGERON POLSKY BS, MPH, RD
Nutritionist
593 EDDY ST, RHODE ISLAND HOSPITAL POB 334
PROVIDENCE, RI 02903
Providence County (401) 444-4422
DR. SUZANNE E MCLAUGHLIN M.D.
Internal Medicine
593 EDDY ST, POB-224 MED/PEDS CLINIC
PROVIDENCE, RI 02903
Providence County (401) 444-6118

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 Jaya Manjunath's NPI number?

The NPI number for Jaya Manjunath is 1871394858. It was assigned to this individual provider in the NPPES registry on March 24, 2025.

Where is Jaya Manjunath located?

Jaya Manjunath practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-7959.

What is Jaya Manjunath's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jaya Manjunath enrolled in Medicare?

Yes. Jaya Manjunath is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jaya Manjunath was last updated on July 1, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.