Individual provider Active NPI

Jwalant K Vadalia, MD

  • Geriatric Psychiatry Physician
  • Manchester, NH
National Provider Identifier
1578550232
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
9203 Issued in NH
Practice address
138 Webster Street
Manchester, NH 03104
Phone
(603) 645-5977
Fax
(603) 645-5980
NPI assigned
Sep 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 9203 NH
Geriatric Psychiatry Physician 2084P0805X 9203 NH Primary

Addresses

Primary practice location

138 Webster Street
Manchester, NH 03104

Mailing address

P.O. Box 3300
Manchester, NH 03105
Phone (603) 645-5977

Other identifiers 3

IdentifierTypeStateIssuer
80003103MedicaidNH
3071621MedicaidNH
0108830Y0NH01OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20080506000233 NH Practitioner - Geriatric PsychiatryPractitioner - Psychiatry 1759272495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric PsychiatryAlso: Psychiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jwalant Vadalia MD PCGroup PAC ID 5698666337, 16 clinicians

Practice addresses (Care Compare)

138 Webster St
Manchester, NH 03104-2512
Phone (603) 645-5977

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
50.01 of 100Reported as group
Quality
7.83
Improvement activities
40
Cost
80.51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jwalant Vadalia MD PC Psychiatry CurrentSince Jul 15, 1994 Accepting new patients

Locations

138 Webster St
Manchester, NH 03104
Phone (603) 645-5977

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1578550232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. 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": {
        "last_name": "VADALIA",
        "first_name": "JWALANT",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-28",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "9203",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NH",
            "license": "9203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80003103",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3071621",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0108830Y0NH01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.