DR. DEEPALI JAIN (MD) – Surgery Physician, NPI 1013203082
Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,444 GENERAL SURGERY in MI
Provider Addresses for DR. DEEPALI JAIN (MD)
1000 MONROE AVE NW
GRAND RAPIDS, MI 495031455
Phone:
Type: Mailing
11511 CANTERWOOD BLVD STE 140
GIG HARBOR, WA 983325817
Phone: (253) 530-2940
Fax: (360) 598-7505
Type: Mailing
67 MAPLE AVE
DERBY, CT 064181328
Phone: (203) 732-3443
Fax: (855) 287-1988
Type: Mailing
350 SEYMOUR AVE STE 2
DERBY, CT 064181336
Phone: (203) 732-3443
Fax: (855) 287-1988
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $26.
Total Amount is formed as General ($26) + Research ($0) + Ownership ($0) = $26.
Last reported payment date: 2023-11-08 • Largest payer in this snapshot: Organogenesis Inc. ($26).
Total Amount
$26
General + Research + Ownership
Payments
1
Total payment records
General Amount
$26
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $26 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-06-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171023000502 | I | General Surgery | WA | TBD |
| I20240613001877 | I | General Surgery | CT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 78 | 78 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 46 | 46 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 37 | 32 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 32 | 31 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 26 | 18 | $0 |
Insurance plans in this area (ZIP 49503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CT | |
| Physician Assistant | CT | |
| Nurse Practitioner | CT | |
| Nurse Practitioner | CT | |
| Nurse Practitioner | CT | |
| - | CT | |
| - | CT | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | MA | |
| General Surgery | CT |
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