Individual provider Active NPI

Chhaya Nanu Maisuria, PSY.D.

  • Clinical Psychologist
  • Manalapan, NJ
National Provider Identifier
1710297023
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00509300 Issued in NJ
Practice address
4 Bridge Plaza Dr
Manalapan, NJ 07726-1746
Phone
(732) 252-8556
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 018833-1 NY
Clinical Psychologist 103TC0700X 35SI00509300 NJ Primary

Addresses

Primary practice location

4 Bridge Plaza Dr
Manalapan, NJ 07726-1746

Mailing address

4 Bridge Plaza Dr
Manalapan, NJ 07726-1746
Phone (732) 252-8556

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131023001095 NJ Practitioner - Clinical Psychologist 1052509213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

215 Gordons Corner Rd
Suite 2F
Manalapan, NJ 07726-3352
Phone (732) 252-8556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018833-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Concepts, P.C. PastSince Apr 24, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1710297023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRIDGE PLAZA DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077261746",
            "telephone_number": "732-252-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BRIDGE PLAZA DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077261746",
            "telephone_number": "732-252-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAISURIA",
        "first_name": "CHHAYA",
        "middle_name": "NANU",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018833-1",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00509300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

Verify at the official NPI Registry.