Individual provider Active NPI

Shaila Maddaiah Maddaiah, MD

  • Psychiatry Physician
  • Princeton, NJ
National Provider Identifier
1760594766
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA05097600 Issued in NJ
Practice address
120 John Street
Family & Childrens Services of Central NJ
Princeton, NJ 08542-3132
Phone
(609) 924-2098
Fax
(609) 924-7826
NPI assigned
Aug 31, 2006
Last updated
May 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2012

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 25MA05097600 NJ Primary

Addresses

Primary practice location

120 John Street
Family & Childrens Services of Central NJ
Princeton, NJ 08542-3132

Mailing address

20 Dorland Farm Court
Skillman, NJ 08558
Phone (609) 924-2098

Other identifiers 1

IdentifierTypeStateIssuer
1047302MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050120000614 NJ Practitioner - Psychiatry 3870542400 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1982
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Oaks Integrated CareGroup PAC ID 6709961857, 32 clinicians

Practice addresses (Care Compare)

819 Alexander Rd
Princeton, NJ 08540-6303
Phone (609) 452-2088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05097600NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health - Behavioral Health Psychiatry CurrentSince May 16, 2003 Accepting new patients
Association for Advancement of Mental Health CurrentSince Apr 15, 2011 Accepting new patients
Rutgers Health - Behavioral Health Psychiatry Current Accepting new patients

Locations

303 George St
Fl 2
New Brunswick, NJ 08901
Phone (732) 235-6800

183 S Orange Ave
Newark, NJ 07103
Phone (973) 972-0004

667 Hoes Ln W
Piscataway, NJ 08854
Phone (732) 235-5730

819 Alexander Rd
Princeton, NJ 08540
Phone (609) 452-2088

Interoperability endpoints

  • Direct secure messaging: smaddaiah387916@epicdirect.rwjbh.org

Organizations & group practices 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1760594766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DORLAND FARM COURT",
            "city": "SKILLMAN",
            "state": "NJ",
            "postal_code": "08558",
            "telephone_number": "609-924-2098",
            "fax_number": "609-924-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 JOHN STREET",
            "address_2": "FAMILY & CHILDRENS SERVICES OF CENTRAL NJ",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085423132",
            "telephone_number": "609-924-2098",
            "fax_number": "609-924-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDAIAH",
        "first_name": "SHAILA",
        "middle_name": "MADDAIAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA05097600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1047302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.