Individual provider Active NPI

Krishan Yalamanchi, MD

  • Pediatric Neurodevelopmental Disabilities Physician
  • Mountainside, NJ
National Provider Identifier
1205804291
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
25MA04666100 Issued in NJ
Practice address
150 New Providence Rd
Mountainside, NJ 07092-2590
Phone
(908) 301-5505
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 25MA04666100 NJ Primary

Addresses

Primary practice location

150 New Providence Rd
Mountainside, NJ 07092-2590

Mailing address

150 New Providence Rd
Mountainside, NJ 07092-2590
Phone (908) 301-5505

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000413 NJ Practitioner - Pediatric Medicine 1658569702 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Specialized Hospital CurrentSince Apr 26, 2016 Accepting new patients
Children' Specialized Hospital CurrentSince Apr 26, 2016 Accepting new patients
Childrens Specialized Hospital Past Accepting new patients

Locations

645 State Route 18
Ste 5
East Brunswick, NJ 08816

150 New Providence Rd
Mountainside, NJ 07092

10 Plum St
New Brunswick, NJ 08901
Phone (732) 235-6333

200 Somerset St
New Brunswick, NJ 08901
Phone (732) 258-7000

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

Organizations & group practices 3

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205804291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NEW PROVIDENCE RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922590",
            "telephone_number": "908-301-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NEW PROVIDENCE RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922590",
            "telephone_number": "908-301-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YALAMANCHI",
        "first_name": "KRISHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NJ",
            "license": "25MA04666100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

Verify at the official NPI Registry.