Active NPI
Shraddha Jadhav
- Psychiatry Physician
- Detroit, MI
National Provider Identifier
1336915891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 61581636
- Practice address
- 259 Mack Ave Ste 2500
Detroit, MI 48201-2427 - Phone
- (313) 577-1716
- NPI assigned
- Nov 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 61581636 | WA | Primary |
| Behavioral Neurology & Neuropsychiatry Physician | 2084B0040X | 61581636 | WA |
Addresses
Primary practice location
259 Mack Ave Ste 2500
Detroit, MI 48201-2427
Mailing address
259 Mack Ave Ste 2500
Detroit, MI 48201-2427
Phone (313) 577-1716
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61581636 | WA | MD | Psychiatry Physician |
Interoperability endpoints
- psychiatrynorthwest.shraddhajadhav@136974.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725494400000",
"number": "1336915891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 MACK AVE STE 2500",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012427",
"telephone_number": "313-577-1716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 MACK AVE STE 2500",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012427",
"telephone_number": "313-577-1716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JADHAV",
"first_name": "SHRADDHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-27",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "61581636",
"primary": true
},
{
"code": "2084B0040X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
"state": "WA",
"license": "61581636",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.