DR. SIDDHARTH JAIN MD NPI 1588847529

NPI Information

NPI: 1588847529
Provider Name: DR. SIDDHARTH JAIN, MD
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Individual

Specialization: Neurology with Special Qualifications in Child Neurology

PECOS Registration: Yes

Address:
1432 S DOBSON RD STE 403
MESA, AZ
ZIP 85202
Phone: (480) 412-7473
Get Directions

DR. Siddharth Jain, MD is a neurology with special qualifications in child neurology psychiatry neurology in Mesa, AZ. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. DR. Siddharth Jain, MD NPI is 1588847529. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1432 S DOBSON RD STE 403
MESA, AZ
ZIP 85202-777
Phone: (480) 412-7473

The NPI 1588847529 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/13/2007 and was last updated on 12/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		2014012628	MISSOURI	No
2	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	61086	ARIZONA	No
3	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	2014012628	MISSOURI	No
4	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	C1118	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1588847529	MEDICAID	MISSOURI
2	ENROLLED	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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