Individual provider Active NPI

Vijay Jayachandran, MD

  • Psychiatry Physician
  • Munster, IN
National Provider Identifier
1114969573
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01041792A Issued in IN
Practice address
1650 45TH St Ste 2a&2B
Munster, IN 46321-3962
Phone
(219) 934-6410
Fax
(219) 924-3143
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01041792A IN Primary

Addresses

Primary practice location

1650 45TH St Ste 2a&2B
Munster, IN 46321-3962

Mailing address

720 45TH Ave
Munster, IN 46321-2818
Phone (219) 934-6410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120410000033 IN Practitioner - Psychiatry 7517128085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Confidential Care, LTD.Group PAC ID 2365426913, 2 clinicians

Practice addresses (Care Compare)

1650 45TH St
Suite C
Munster, IN 46321-3960
Phone (219) 934-6410

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01041792AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Health Centers, Inc. Psychiatry CurrentSince Nov 9, 2020 Accepting new patients
Northshore Health Centers Inc Current Accepting new patients
Northshore Health Centers, Inc. CurrentSince Nov 9, 2020 Accepting new patients
Major Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188

Interoperability endpoints

  • Direct secure messaging: vijayalakshmi.jayachandran.p1@direct.northshorehealth.nextgenshare.com

Organizations & group practices 6

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1114969573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 45TH AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212818",
            "telephone_number": "219-934-6410",
            "fax_number": "219-924-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 45TH ST STE 2A&2B",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213962",
            "telephone_number": "219-934-6410",
            "fax_number": "219-924-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYACHANDRAN",
        "first_name": "VIJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01041792A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.