Individual provider Active NPI

Chetna A Dave, MD

  • Internal Medicine Physician
  • Stratford, NJ
National Provider Identifier
1831179134
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06337900 Issued in NJ
Practice address
42 E Laurel Rd Ste 1800
Stratford, NJ 08084-1338
Phone
(856) 566-6843
Fax
(856) 566-6419
NPI assigned
Jan 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MA63379 NJ
Nephrology Physician 207RN0300X 25MA06337900 NJ
Internal Medicine Physician 207R00000X 25MA06337900 NJ Primary

Addresses

Primary practice location

42 E Laurel Rd Ste 1800
Stratford, NJ 08084-1338

Mailing address

42 E Laurel Rd Ste 1800
Stratford, NJ 08084-1338
Phone (856) 566-6843

Other identifiers 1

IdentifierTypeStateIssuer
7792905MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdave249065@directvirtua.org

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
I20050525000033 NJ Practitioner - Internal MedicinePractitioner - Nephrology 9234171794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06337900NJMDInternal Medicine Physician
MA63379NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Virtua Medical Group, PA Internal Medicine Current Accepting new patients
Rowansom New Jersey Institute for Successful Aging Internal Medicine CurrentSince Jan 31, 2011 Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry Current Accepting new patients
Gericare Assoc LLC Past Accepting new patients
The Palace Rehabilitation and Care Center LLC Past Accepting new patients
The Silvercare LLC Past Accepting new patients
Gericare Associates Past Accepting new patients
The Silvercare LLC Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

303 Lippincott Dr
Marlton, NJ 08053

42 E Laurel Rd
Ste 1800
Stratford, NJ 08084
Phone (609) 566-6843

Interoperability endpoints

  • Direct secure messaging: cdave249065@directvirtua.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Palace Rehabilitation and Care Center LLCMaple Shade, NJ, CCN 315263 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1831179134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841338",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841338",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "CHETNA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA63379",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA06337900",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06337900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7792905",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdave249065@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 1800",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.