Individual provider Active NPI

Jada Marie Khosla, M.D.

  • Psychiatry Physician
  • Montpelier, VT
National Provider Identifier
1457474272
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
042.0017261 Issued in VT
Practice address
147 State St
Montpelier, VT 05602-3301
Phone
(802) 321-3692
Fax
(833) 450-5181
NPI assigned
Apr 8, 2007
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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 042.0017261 VT Primary

Addresses

Primary practice location

147 State St
Montpelier, VT 05602-3301

Mailing address

195 Vincent Flats Rd
East Montpelier, VT 05651-4070
Phone (646) 361-2659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, OR, WA, NY, VT5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20151022002379 NJ Practitioner - Psychiatry 0648589192 Reassigns benefits to 1 organization
I20180719001580 OR Practitioner - Psychiatry 0648589192 Reassigns benefits to 1 organization
I20180822002828 WA Practitioner - Psychiatry 0648589192 Reassigns benefits to 1 organization
I20210402000263 NY Practitioner - Psychiatry 0648589192 Reassigns benefits to 1 organization
I20231213003949 VT Practitioner - Psychiatry 0648589192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Vermont College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partners in Integrative Healing PLLCGroup PAC ID 4486004348, 4 clinicians

Practice addresses (Care Compare)

147 State St
Montpelier, VT 05602-3301
Phone (802) 321-3692

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Integrative Healing PLLC Psychiatry CurrentSince Dec 1, 2023 Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Oct 14, 2022 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jul 30, 2018 Accepting new patients
Barnabas Health Medical Group, PC CurrentSince Aug 22, 2015 Accepting new patients
State Street TMS Psychiatry CurrentSince Oct 3, 2023 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jul 30, 2018 Accepting new patients
Legacy Clinics LLC CurrentSince Jun 1, 2018 Accepting new patients

Locations

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

147 State St
Montpelier, VT 05602
Phone (802) 321-3692

147 State St
#1
Montpelier, VT 05602

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 7

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": "1175990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1457474272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 VINCENT FLATS RD",
            "city": "EAST MONTPELIER",
            "state": "VT",
            "postal_code": "056514070",
            "telephone_number": "646-361-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 STATE ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056023301",
            "telephone_number": "802-321-3692",
            "fax_number": "833-450-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSLA",
        "first_name": "JADA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-08",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042.0017261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montpelier, VT

Sources for this page

Verify at the official NPI Registry.