Individual provider Active NPI

Kinjal Janak Ghelani, M.D.

  • Psychiatry Physician
  • Daphne, AL
National Provider Identifier
1083970701
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34588 Issued in AL
Practice address
7400 Roper LN
Daphne, AL 36526-5274
Phone
(251) 706-5551
NPI assigned
Apr 6, 2012
Last updated
Jul 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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
Psychiatry Physician 2084P0800X 34588 AL Primary

Addresses

Primary practice location

7400 Roper LN
Daphne, AL 36526-5274

Mailing address

5750A Southland Dr
Mobile, AL 36693-3316
Phone (251) 706-5551

Other names 1

  • Kinjal Jaysukh Mashru Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 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
I20160822002191 AL Practitioner - Psychiatry 3971753732 Reassigns benefits to 1 organization
I20201109002595 GA Practitioner - Psychiatry 3971753732 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mahantkeshavjivandas LLC Psychiatry CurrentSince Oct 1, 2020 Accepting new patients
Altapointe Health Systems, Inc. Past Accepting new patients

Locations

3929 Airport Blvd
#2306
Mobile, AL 36609
Phone (251) 283-0003

3993 Lawrenceville Hwy NW
Ste 140
Lilburn, GA 30047
Phone (404) 835-1575

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": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1083970701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750A SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933316",
            "telephone_number": "251-706-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 ROPER LN",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365265274",
            "telephone_number": "251-706-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHELANI",
        "first_name": "KINJAL",
        "middle_name": "JANAK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-06",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "34588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KINJAL",
            "last_name": "MASHRU",
            "middle_name": "JAYSUKH",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Daphne, AL

Sources for this page

Verify at the official NPI Registry.