Active NPI
Jayaprakash B Shetty, MD
- Psychiatry Physician
- Willimantic, CT
National Provider Identifier
1700844271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25058
- Practice address
- 132 Mansfield Avenue
Willimantic, CT 06226-2027 - Phone
- (860) 456-2261
- Fax
- (860) 450-1357
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25058 | CT | Primary |
Addresses
Primary practice location
132 Mansfield Avenue
Willimantic, CT 06226-2027
Mailing address
1007 N Main Stret
Dayville, CT 06241-0839
Phone (860) 774-2020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medoptions Behavioral Health Assoc, LLC | Psychiatry | Past | Accepting new patients |
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.
-
- Nurse Practitioner
- Old Saybrook, CT
- NPI 1588604060
Psychiatry
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342051200000",
"number": "1700844271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 N MAIN STRET",
"city": "DAYVILLE",
"state": "CT",
"postal_code": "062410839",
"telephone_number": "860-774-2020",
"fax_number": "860-779-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 MANSFIELD AVENUE",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062262027",
"telephone_number": "860-456-2261",
"fax_number": "860-450-1357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHETTY",
"first_name": "JAYAPRAKASH",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2012-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "25058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.