Individual provider Active NPI

Vidhyalakshmi V Jaishankar, M.D.

  • Child & Adolescent Psychiatry Physician
  • Winter Park, FL
National Provider Identifier
1801992482
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
ME119998 Issued in FL
Practice address
1573 W Fairbanks Ave Ste 100
Winter Park, FL 32789
Phone
(407) 896-8097
Fax
(407) 898-8328
NPI assigned
Sep 15, 2006
Last updated
Aug 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35088297 OH
Psychiatry Physician 2084P0800X ME119998 FL
Child & Adolescent Psychiatry Physician 2084P0804X 35088297 OH
Child & Adolescent Psychiatry Physician 2084P0804X ME119998 FL Primary

Addresses

Primary practice location

1573 W Fairbanks Ave Ste 100
Winter Park, FL 32789

Mailing address

1573 W Fairbanks Ave Ste 100
Winter Park, FL 32789-4679
Phone (407) 896-8097

Other practice location 1

526 W Lake Mary Blvd
Sanford, FL 32773-7467
Phone (800) 614-4124

Other identifiers 1

IdentifierTypeStateIssuer
014226400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150604000986 FL Practitioner - Psychiatry 2860565975 Reassigns benefits to 2 organizations
I20240905002827 NC Practitioner - Psychiatry 2860565975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians
MCPC-11 LLCGroup PAC ID 1153564877, 29 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

35 Memorial Dr
Pinehurst, NC 28374-8708
Phone (910) 715-3376

Merit-based Incentive Payment System (MIPS)

Final score
98.64 of 100Reported as group
Quality
94.98
Promoting interoperability
86
Improvement activities
40
Cost
94.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35088297OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Psychiatry CurrentSince Aug 19, 2019 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 19, 2019 Accepting new patients
Asana Integrated Medical Group PC Psychiatry CurrentSince Feb 16, 2019 Accepting new patients
MCPC-11, LLC CurrentSince Jun 9, 2024 Accepting new patients
Coastal Mental Health Center Inc Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

35 Memorial Dr
Pinehurst, NC 28374
Phone (910) 715-3376

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: vjaishankar73877@adventhealth.direct-ci.com

Organizations & group practices 5

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1801992482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894679",
            "telephone_number": "407-896-8097",
            "fax_number": "407-898-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32789",
            "telephone_number": "407-896-8097",
            "fax_number": "407-898-8328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "526 W Lake Mary Blvd",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "327737467",
            "country_code": "US",
            "telephone_number": "800-614-4124",
            "fax_number": "407-878-3789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAISHANKAR",
        "first_name": "VIDHYALAKSHMI",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35088297",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME119998",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "35088297",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME119998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014226400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.