Individual provider Active NPI

Lalitha Chandrasekhara, MD

  • Psychiatry Physician
  • Goshen, NY
National Provider Identifier
1255477782
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
179774-1 Issued in NY
Practice address
2001 Route 17M
Goshen, NY 10924-5228
Phone
(845) 294-6185
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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 179774-1 NY Primary

Addresses

Primary practice location

2001 Route 17M
Goshen, NY 10924-5228

Mailing address

2001 Route 17M
Goshen, NY 10924-5228
Phone (845) 294-6185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040708001252 NY Practitioner - Psychiatry 1355329145 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179774-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access: Supports for Living Inc. CurrentSince Sep 12, 1997 Accepting new patients
Access: Supports for Living Inc CurrentSince Sep 12, 1997 Accepting new patients

Locations

2001 Route 17M
Goshen, NY 10924
Phone (845) 294-6185

16 Union St
Middletown, NY 10940
Phone (845) 343-5556

67 Windsor Hwy
Newburgh, NY 12553
Phone (845) 562-6850

15 Fortune Rd W
Scotchtown, NY 10941
Phone (845) 673-7123

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1255477782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 ROUTE 17M",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109245228",
            "telephone_number": "845-294-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 ROUTE 17M",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109245228",
            "telephone_number": "845-294-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRASEKHARA",
        "first_name": "LALITHA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "179774-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

Verify at the official NPI Registry.