Individual provider Active NPI

Roshni Panchal, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1023423415
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA10292500 Issued in NJ
Practice address
109 W 27TH St Ste 5S
New York, NY 10001-6208
Phone
(917) 634-5311
NPI assigned
Jun 25, 2014
Last updated
May 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X C7-0005569 DE
Psychiatry Physician 2084P0800X 25MA10292500 NJ Primary

Addresses

Primary practice location

109 W 27TH St Ste 5S
New York, NY 10001-6208

Mailing address

109 W 27TH St Ste 5S
New York, NY 10001-6208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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
I20220503000823 NJ Practitioner - Psychiatry 1759778160 Reassigns benefits to 1 organization
I20220601001824 NY Practitioner - Psychiatry 1759778160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD New Jersey Psychiatry Services LLCGroup PAC ID 8921452350, 54 clinicians

Practice addresses (Care Compare)

53 Frontage Rd
Hampton, NJ 08827-4031
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317072NYMDLicensed Practical Nurse
25MA10292500NJMDPsychiatry Physician
C7-0005569DEMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD New Jersey Psychiatry Services LLC Psychiatry CurrentSince Jul 19, 2023 Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Jun 1, 2022 Accepting new patients

Locations

53 Frontage Rd
Fl 1
Hampton, NJ 08827
Phone (908) 386-2572

525 Route 73 N
Ste 117
Marlton, NJ 08053
Phone (609) 200-0444

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1023423415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST STE 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST STE 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "917-634-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "ROSHNI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DE",
            "license": "C7-0005569",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA10292500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.