Individual provider Active NPI

Shivani H Vaidya, DO

  • Neurology Physician
  • Winston Salem, NC
National Provider Identifier
1013545714
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MB12770300 Issued in NJ
Practice address
Medical Center Blvd
Winston Salem, NC 27157-2113
Phone
(336) 716-2261
Fax
(336) 716-9810
NPI assigned
Mar 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2024-01522 NC
Student in an Organized Health Care Education/Training Program 390200000X 2024-01522 NC
Neurology Physician 2084N0400X 25MB12770300 NJ Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-2113

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2261

Other practice location 1

77 Veronica Ave Ste 102
Somerset, NJ 08873-6804
Phone (732) 246-1311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240909003919 NC Practitioner - Neurology 6103366810 Reassigns benefits to 1 organization
I20250912002566 NJ Practitioner - Neurology 6103366810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians

Practice addresses (Care Compare)

800 Bunn Dr
Suite 204
Princeton, NJ 08540-1968
Phone (609) 497-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 8, 2024 Accepting new patients
The Radiology Group of New Jersey, LLC CurrentSince Sep 1, 2025 Accepting new patients
Monmouth Digestive Health LLC PastSince Aug 17, 2020 Accepting new patients
Princeton and Rutger Neurology, P.a. Neurology Past Accepting new patients

Locations

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

145 Wyckoff Rd
Ste 201
Eatontown, NJ 07724
Phone (732) 597-7333

57 US Highway 46
Ste 212
Hackettstown, NJ 07840

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

9 Centre Dr
Ste 130
Monroe Twp, NJ 08831
Phone (609) 395-7615

175 High St
Newton, NJ 07860
Phone (973) 383-2121

800 Bunn Dr
Ste 204
Princeton, NJ 08540
Phone (609) 430-9200

77 Veronica Ave
Ste 102
Somerset, NJ 08873
Phone (732) 246-1311

77 Veronica Ave
Somerset, NJ 08873
Phone (732) 246-1311

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1013545714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2261",
            "fax_number": "336-716-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271572113",
            "telephone_number": "336-716-2261",
            "fax_number": "336-716-9810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Veronica Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "NJ",
            "postal_code": "088736804",
            "country_code": "US",
            "telephone_number": "732-246-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "SHIVANI",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-29",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2024-01522",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "2024-01522",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MB12770300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.