Individual provider Active NPI

Kajal G Zalavadia, M.D.

  • Obesity Medicine (Internal Medicine) Physician
  • New Canaan, CT
National Provider Identifier
1497912604
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
License
2016-01492 Issued in NC
Practice address
69 Grove St
New Canaan, CT 06840-5325
Phone
(844) 359-8363
Fax
(833) 929-3520
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 1992372403 CT
Medical Specialty Clinic/Center 261QM2500X 25MA11643800 NJ
Medical Specialty Clinic/Center 261QM2500X 2016-01492 NC
Medical Specialty Clinic/Center 261QM2500X 319255 NY
Medical Specialty Clinic/Center 261QM2500X MD443258 PA
Medical Specialty Clinic/Center 261QM2500X 1043889967 NY
Medical Specialty Clinic/Center 261QM2500X 72803 CT
Obesity Medicine (Internal Medicine) Physician 207RB0002X 2016-01492 NC Primary

Addresses

Primary practice location

69 Grove St
New Canaan, CT 06840-5325

Mailing address

5109 Gansett LN
Raleigh, NC 27612-3694
Phone (732) 809-3284

Other practice location 1

148 E 38th St
New York, NY 10016-2607
Phone (844) 359-8363

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
1992372403CTMDMedical Specialty Clinic/Center
72803CTMDMedical Specialty Clinic/Center
2016-01492NCMDMedical Specialty Clinic/Center
25MA11643800NJMDMedical Specialty Clinic/Center
1043889967NYMDMedical Specialty Clinic/Center
319255NYMDMedical Specialty Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Dec 5, 2014 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Inova Health Care Services CurrentSince Dec 5, 2014 Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Aug 22, 2019 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

160 Macgregor Pines Dr
Cary, NC 27511
Phone (919) 233-0488

160 Macgregor Pines Dr
Ste 310
Cary, NC 27511
Phone (919) 234-4470

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

2920 Highwoods Blvd
Raleigh, NC 27604

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

Organizations & group practices 6

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1497912604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 GANSETT LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123694",
            "telephone_number": "732-809-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 GROVE ST",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068405325",
            "telephone_number": "844-359-8363",
            "fax_number": "833-929-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "148 E 38th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100162607",
            "country_code": "US",
            "telephone_number": "844-359-8363",
            "fax_number": "833-955-3592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZALAVADIA",
        "first_name": "KAJAL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CT",
            "license": "1992372403",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "25MA11643800",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": "2016-01492",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "319255",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "PA",
            "license": "MD443258",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "1043889967",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CT",
            "license": "72803",
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "NC",
            "license": "2016-01492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Canaan, CT

Sources for this page

Verify at the official NPI Registry.