Individual provider Active NPI

Paul Chellappa, MD

  • Psychiatry Physician
  • Middletown, NY
National Provider Identifier
1679561476
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1116701 Issued in NY
Practice address
45 Ashley Ave
Middletown, NY 10940-1912
Phone
(845) 342-7448
Fax
(845) 326-8157
NPI assigned
Oct 6, 2005
Last updated
May 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 1116701 NY Primary

Addresses

Primary practice location

45 Ashley Ave
Middletown, NY 10940-1912

Mailing address

45 Ashley Ave
Middletown, NY 10940-1912
Phone (845) 341-7448

Other practice location 1

23 Starhaven Ave
Middletown, NY 10940-4627
Phone (845) 341-7448

Other identifiers 1

IdentifierTypeStateIssuer
00542503MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240611000187 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 0648234419

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1116701NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
County of Sullivan PastSince Dec 8, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: paulchellappa@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1679561476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 ASHLEY AVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109401912",
            "telephone_number": "845-341-7448",
            "fax_number": "845-326-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ASHLEY AVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109401912",
            "telephone_number": "845-342-7448",
            "fax_number": "845-326-8157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Starhaven Ave",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109404627",
            "country_code": "US",
            "telephone_number": "845-341-7448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHELLAPPA",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "1116701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00542503",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.