Individual provider Active NPI

John J Naliyath, M.D

  • Psychiatry Physician
  • Fort Pierce, FL
National Provider Identifier
1912268301
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME124213 Issued in FL
Practice address
1870 N Lawnwood Cir
Ste a
Fort Pierce, FL 34950-4828
Phone
(772) 461-0820
Fax
(772) 461-0823
NPI assigned
Jun 2, 2012
Last updated
Mar 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X FR0435669133 NY
Psychiatry Physician 2084P0800X ME124213 FL Primary

Addresses

Primary practice location

1870 N Lawnwood Cir
Ste a
Fort Pierce, FL 34950-4828

Mailing address

1870 N Lawnwood Cir
Ste a
Fort Pierce, FL 34950-4828
Phone (772) 461-0820

Other identifiers 1

IdentifierTypeStateIssuer
015580200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20151117001776 FL Practitioner - Psychiatry 6709196066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Florida Behavioral Health Network, LLCGroup PAC ID 7810160249, 9 clinicians

Practice addresses (Care Compare)

1700 S 23Rd St
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
FR0435669133NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coral Shores Behavioral Health, LLC Psychiatry CurrentSince Jan 10, 2023 Accepting new patients
East Florida Behavioral Health Network, LLC Psychiatry CurrentSince Aug 1, 2015 Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

5995 SE Community Dr
Stuart, FL 34997
Phone (727) 424-3427

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1912268301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 N LAWNWOOD CIR",
            "address_2": "STE A",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504828",
            "telephone_number": "772-461-0820",
            "fax_number": "772-461-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 N LAWNWOOD CIR",
            "address_2": "STE A",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504828",
            "telephone_number": "772-461-0820",
            "fax_number": "772-461-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALIYATH",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-02",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "FR0435669133",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME124213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015580200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.