Shaismy Kudakachira, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA00000X Issued in NJ

Practice address

850 Bear Tavern Rd
Ewing, NJ 08628-1018

Phone

(609) 656-8844

Fax

(609) 656-8845

NPI assigned

May 27, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

West Virginia School of Osteopathic Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercer Care Home health agency, Bordentown, NJ, CCN 317062
• Robert Wood Johnson Visiting Nurses, Inc Home health agency, North Brunswick, NJ, CCN 317079
• Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
• Capital Health Regional Medical Center Hospital, Trenton, NJ, CCN 310092

Merit-based Incentive Payment System (MIPS)

Final score

96.91 of 100Reported as apm

Quality

79.42

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4
• Direct secure messaging: shaismy.kudakachira.1@12833.direct.athenahealth.com

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.

• Capital Health Medical Group

  • Internal Medicine Physician
  • Trenton, NJ
  • NPI 1437516887
  Medicare reassignment Care Compare group NPD

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

• Capital Health System Inc

  dba Regional Medical Center

  • General Acute Care Hospital
  • Trenton, NJ
  • NPI 1275583726
  Care Compare affiliation
• Capital Health System, Inc.

  dba Capital Health Medical Center - Hopewell

  • General Acute Care Hospital
  • Pennington, NJ
  • NPI 1073516183
  Care Compare affiliation
• Mercer Care Partners Medical Home Health Care LLC

  • Home Health Agency
  • Bordentown, NJ
  • NPI 1336575919
  Care Compare affiliation
• Robert Wood Johnson Visiting Nurses, Inc.

  • Home Health Agency
  • North Brunswick, NJ
  • NPI 1588809248
  Care Compare affiliation
• Robert Wood Johnson Visiting Nurses, Inc.

  • Community Based Hospice Care Agency
  • North Brunswick, NJ
  • NPI 1700968609

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205248192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BEAR TAVERN RD",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086281018",
            "telephone_number": "609-656-8844",
            "fax_number": "609-656-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BEAR TAVERN RD",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086281018",
            "telephone_number": "609-656-8844",
            "fax_number": "609-656-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDAKACHIRA",
        "first_name": "SHAISMY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-27",
        "last_updated": "2022-07-21",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shaismy.kudakachira.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "850 Bear Tavern Rd",
            "city": "Ewing",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "086281018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Internal Medicine Physician in Ewing, NJ
• Providers in Ewing, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.