Individual provider Active NPI

Uvadee Chaibongsai, MD

  • Diagnostic Radiology Physician
  • Maplewood, NJ
National Provider Identifier
1912952433
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA03808100 Issued in NJ
Practice address
2130 Millburn Avenue
Maplewood, NJ 07040
Phone
(973) 912-0404
Fax
(973) 912-0444
NPI assigned
May 23, 2006
Last updated
May 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA03808100 NJ Primary

Addresses

Primary practice location

2130 Millburn Avenue
Maplewood, NJ 07040

Mailing address

2130 Millburn Avenue
Maplewood, NJ 07040
Phone (973) 912-0404

Other identifiers 1

IdentifierTypeStateIssuer
3615308MedicaidNJ

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03808100NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concierge Breast Imaging & Radiological Services, P.C. PastSince Feb 3, 2010 Accepting new patients
University Radiology at Trinitas, LLC Diagnostic Radiology PastSince Jul 1, 2008 Accepting new patients
Elizabeth Radiology Associates, P.a. Diagnostic Radiology Past Accepting new patients
Diagnostic Imaging of Elizabeth LLC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 4

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1912952433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVENUE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "07040",
            "telephone_number": "973-912-0404",
            "fax_number": "973-912-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVENUE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "07040",
            "telephone_number": "973-912-0404",
            "fax_number": "973-912-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIBONGSAI",
        "first_name": "UVADEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA03808100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3615308",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.