Individual provider Active NPI

Ravinder N Bhalla, MD

  • Child & Adolescent Psychiatry Physician
  • Ridgewood, NJ
National Provider Identifier
1841214566
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
25MA04911600 Issued in NJ
Practice address
65 N Maple Ave
Ridgewood, NJ 07450-3233
Phone
(201) 652-4999
Fax
(973) 471-1630
NPI assigned
Jul 26, 2006
Last updated
Apr 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 25MA04911600 NJ Primary

Addresses

Primary practice location

65 N Maple Ave
Ridgewood, NJ 07450-3233

Mailing address

65 N Maple Ave
Ridgewood, NJ 07450-3233
Phone (201) 652-4999

Other identifiers 1

IdentifierTypeStateIssuer
5083508MedicaidNJ

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
I20110616000832 NJ Practitioner - PsychiatryPractitioner - Other (Physician) 4486832615 Reassigns benefits to 1 organization
Practice locations: Ridgewood, NJ

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

65 N Maple Ave
Ridgewood, NJ 07450-3233
Phone (201) 652-4999

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Clinic of Passaic Inc CurrentSince Oct 8, 1990 Accepting new patients

Locations

1451 Van Houten Ave
Clifton, NJ 07013
Phone (973) 473-2775

111 Lexington Ave
Passaic, NJ 07055
Phone (973) 471-8006

124 Gregory Ave
Ste 202
Passaic, NJ 07055
Phone 9739287244 ext. 102

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/mhcp/r4/

Organizations & group practices 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1841214566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503233",
            "telephone_number": "201-652-4999",
            "fax_number": "973-471-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503233",
            "telephone_number": "201-652-4999",
            "fax_number": "973-471-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHALLA",
        "first_name": "RAVINDER",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA04911600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5083508",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.