Individual provider Active NPI

Shashi Elangovan

  • Child & Adolescent Psychiatry Physician
  • Staten Island, NY
National Provider Identifier
1356462246
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
188434 Issued in NY
Practice address
777 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 667-2300
NPI assigned
Apr 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Child & Adolescent Psychiatry Physician 2084P0804X 188434 NY Primary

Addresses

Primary practice location

777 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

777 Seaview Ave
Staten Island, NY 10305-3436

Other identifiers 1

IdentifierTypeStateIssuer
188434MedicaidNY

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
I20200413002645 NY Practitioner - Psychiatry 6406124510 Reassigns benefits to 2 organizations
Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elangovan Psychiatric Services PLLCGroup PAC ID 2860867447, 6 clinicians

Practice addresses (Care Compare)

1756 Richmond Ave
Staten Island, NY 10314-3902
Phone (718) 477-5670

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
188434NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elangovan Psychiatric Services LLC CurrentSince Apr 19, 2022 Accepting new patients

Locations

1756 Richmond Ave
Staten Island, NY 10314
Phone (718) 477-5670

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356462246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-667-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELANGOVAN",
        "first_name": "SHASHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "188434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188434",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.