NPIMap

Organization Active NPI

Jwalant Vadalia MD PC

  • Psychiatry Physician
  • Manchester, NH
National Provider Identifier
1346329133
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JWALANT VADALIA MD PC
Practice address
138 Webster Street
Manchester, NH 03104
Phone
(603) 645-5977
Fax
(603) 645-5980
NPI assigned
Nov 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jwalant K Vadalia, MDNPI 1578550232
Title
President
Phone
(603) 645-5977

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

138 Webster Street
Manchester, NH 03104

Mailing address

PO Box 3300
Manchester, NH 03105
Phone (603) 645-5977

Other identifiers 2

IdentifierTypeStateIssuer
30010809MedicaidNH
CI6332OtherNHR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000491 NH Part B Supplier - Clinic/Group Practice 5698666337 Receives reassigned benefits from 19 practitioners
Practice locations: Manchester, NH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346329133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03105",
            "telephone_number": "603-645-5977",
            "fax_number": "603-645-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 WEBSTER STREET",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03104",
            "telephone_number": "603-645-5977",
            "fax_number": "603-645-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JWALANT VADALIA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VADALIA",
        "authorized_official_first_name": "JWALANT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-645-5977",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30010809",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R MEDICARE",
            "identifier": "CI6332",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.