Individual provider Active NPI

Chandni Bhalodia, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Brick, NJ
National Provider Identifier
1023646262
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1759 Route 88 Unit 203
Brick, NJ 08724-3016
Phone
(856) 424-5005
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X 25MP00876600 NJ
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1759 Route 88 Unit 203
Brick, NJ 08724-3016

Mailing address

2301 East Evesham Road BLDG 800, Ste 115
Voorhees, NJ 08043-4509
Phone (856) 424-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250110002404 NJ Practitioner - Physician Assistant 5890109888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trabecular Medical Group, LLCGroup PAC ID 2365842440, 19 clinicians

Practice addresses (Care Compare)

1759 Hwy 88 W
Laurelton Plaza
Brick, NJ 08724-3016
Phone (856) 424-5005

2301 E Evesham Rd
BLDG 800 Suite 115
Voorhees, NJ 08043-4509
Phone (856) 424-5005

354 Hurffville Crosskeys Rd
Sewell, NJ 08080-3552
Phone (856) 424-5005

740 Marne Hwy
Suite 102
Moorestown, NJ 08057-3126
Phone (856) 424-5005

Hospital & facility affiliations

  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00876600NJMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis & Rheumatic Disease Assoc. Single Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cbhalodia@arthritis.medentdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1023646262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 EAST EVESHAM ROAD BLDG 800, STE 115",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434509",
            "telephone_number": "856-424-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 ROUTE 88 UNIT 203",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243016",
            "telephone_number": "856-424-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHALODIA",
        "first_name": "CHANDNI",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NJ",
            "license": "25MP00876600",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.