Individual provider Active NPI

Shivana Devi Naidoo, M.D.

  • Child & Adolescent Psychiatry Physician
  • Riverside, RI
National Provider Identifier
1366769093
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD18812 Issued in RI
Practice address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5099
Phone
(401) 444-6779
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 271265 NY
Child & Adolescent Psychiatry Physician 2084P0804X MD18812 RI Primary

Addresses

Primary practice location

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5099

Mailing address

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5099
Phone (401) 444-6779

Other practice location 1

2190 N Grace Blvd
Chandler, AZ 85225-3416
Phone (623) 308-2472

Other identifiers 2

IdentifierTypeStateIssuer
1578768867MedicaidRI
1548506793MedicaidRI

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
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
271265NYMDChild & Adolescent Psychiatry Physician
MD18812RIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc CurrentSince Aug 20, 2015 Accepting new patients
Emma Pendleton Bradley Hospital Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Nov 25, 2022 Accepting new patients
Emma Pendleton Bradley Hospital Psychiatry CurrentSince Nov 7, 2022 Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Lifespan Physician Group, Inc. Psychiatry CurrentSince Nov 25, 2022 Accepting new patients
Albany Medical College CurrentSince Sep 4, 2018 Accepting new patients
Albany Medical College Psychiatry CurrentSince Sep 4, 2018 Accepting new patients

Locations

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

25 Hackett Blvd
Albany, NY 12208
Phone (518) 262-1200

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
Menands, NY 12204
Phone (518) 262-9705

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Providence, RI 02903

1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000

Organizations & group practices 9

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": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1366769093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155099",
            "telephone_number": "401-444-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155099",
            "telephone_number": "401-444-6779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2190 N Grace Blvd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852253416",
            "country_code": "US",
            "telephone_number": "623-308-2472",
            "fax_number": "623-218-9061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAIDOO",
        "first_name": "SHIVANA",
        "middle_name": "DEVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "271265",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "RI",
            "license": "MD18812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578768867",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548506793",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.