Individual provider Active NPI

Chaitali Shah

  • Psychiatric/Mental Health Nurse Practitioner
  • Short Hills, NJ
National Provider Identifier
1669174041
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01454800 Issued in NJ
Practice address
51 JFK Pkwy FL 1
Short Hills, NJ 07078-2713
Phone
(917) 582-6622
Fax
(888) 974-2142
NPI assigned
Mar 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01454800 NJ Primary

Addresses

Primary practice location

51 JFK Pkwy FL 1
Short Hills, NJ 07078-2713

Mailing address

51JFK Parkway
1St Floor West
Short Hills, NJ 07078
Phone (917) 582-6622

Other practice location 1

30 Silver Holw
North Brunswick, NJ 08902-2663
Phone (201) 850-7426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230426002047 NJ Practitioner - Nurse Practitioner 1456716455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nynj Psychiatric Associates LLCGroup PAC ID 2961689989, 38 clinicians

Practice addresses (Care Compare)

51 JFK Pkwy
Short Hills, NJ 07078-2704
Phone (917) 582-6622

Merit-based Incentive Payment System (MIPS)

Final score
87.66 of 100Reported as group
Quality
74.82
Improvement activities
40
Cost
71.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ01454800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nynj Psychiatric Associates LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

395 Grand St
Jersey City, NJ 07302
Phone (201) 915-2600

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.

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1669174041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51JFK PARKWAY",
            "address_2": "1ST FLOOR WEST",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "07078",
            "telephone_number": "917-582-6622",
            "fax_number": "888-974-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 JFK PKWY FL 1",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070782713",
            "telephone_number": "917-582-6622",
            "fax_number": "888-974-2142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Silver Holw",
            "address_purpose": "LOCATION",
            "city": "North Brunswick",
            "state": "NJ",
            "postal_code": "089022663",
            "country_code": "US",
            "telephone_number": "201-850-7426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "CHAITALI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01454800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Short Hills, NJ

Sources for this page

Verify at the official NPI Registry.