Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaya Phookan, MD

Individual provider Internal Medicine Physician · NPI 1417187493

Jaya Phookan, MD is an Internal Medicine in Green Bay, Wisconsin. Qualified in 2005, 21 years ago. Licensed in Wisconsin.

Years since qualifying
21
Licensed in
WI
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone: (920) 288-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence 66307 (WI)
Internal Medicine Physician Taxonomy 207R00000X · Licence 66307 (WI)

Record details

NPI number1417187493
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 23, 2009
Last updated in NPPESNovember 30, 2021
Certification dateNovember 30, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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