Individual provider Active NPI

Jyothsna S Shastry, MD

  • Occupational Medicine Physician
  • Toms River, NJ
National Provider Identifier
1811013675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
2503543900 Issued in NJ
Practice address
1430 Hooper Ave
Ste 200 B
Toms River, NJ 08753-2895
Phone
(732) 557-0700
Fax
(732) 557-9159
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 2503543900 NJ Primary

Addresses

Primary practice location

1430 Hooper Ave
Ste 200 B
Toms River, NJ 08753-2895

Mailing address

66 Green Meadow Blvd
Middletown, NJ 07748-3148

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2503543900NJMDOccupational Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811013675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 GREEN MEADOW BLVD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077483148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 HOOPER AVE",
            "address_2": "STE 200 B",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087532895",
            "telephone_number": "732-557-0700",
            "fax_number": "732-557-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASTRY",
        "first_name": "JYOTHSNA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NJ",
            "license": "2503543900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.