Individual provider Active NPI

Jayanthi Periasamy, MD

  • Psychiatry Physician
  • Somerset, NJ
National Provider Identifier
1912966573
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA07322300 Issued in NJ
Practice address
100 Davidson Ave Ste 203
Somerset, NJ 08873-1312
Phone
(732) 563-0033
Fax
(732) 563-0035
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA07322300 NJ Primary

Addresses

Primary practice location

100 Davidson Ave Ste 203
Somerset, NJ 08873-1312

Mailing address

100 Davidson Ave Ste 203
Somerset, NJ 08873-1312
Phone (732) 563-0033

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
I20050831000683 NJ Practitioner - Psychiatry 0547292401 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valeo Behavioral Health, Inc.Group PAC ID 0042487233, 7 clinicians

Practice addresses (Care Compare)

2911 Route 88
Suite E8
Point Pleasant Boro, NJ 08742-2871
Phone (732) 295-1008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07322300NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnicle Behavioral Health, LLC CurrentSince May 2, 2010 Accepting new patients
Valeo Behavioral Health, Inc. CurrentSince Oct 29, 2011 Accepting new patients
Rutgers Health - Behavioral Health Psychiatry CurrentSince Jan 22, 2020 Accepting new patients
Rutgers Health - Behavioral Health Psychiatry Current Accepting new patients
Insights Behavioral Health, LLC Psychiatry Past Accepting new patients
Bridges Behavioral Health Care Psychiatry Past Accepting new patients
Meridian Hospitals Corporation, Inc. Dba Jersey Shore University Medic Psychiatry Past Accepting new patients

Locations

100 Metroplex Dr
Fl 2
Edison, NJ 08817

183 S Orange Ave
Newark, NJ 07103
Phone (973) 972-0004

667 Hoes Ln W
Piscataway, NJ 08854
Phone (732) 235-5730

2911 Route 88
Ste E8
Point Pleasant Boro, NJ 08742
Phone (732) 295-1008

Organizations & group practices 7

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1912966573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DAVIDSON AVE STE 203",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731312",
            "telephone_number": "732-563-0033",
            "fax_number": "732-563-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DAVIDSON AVE STE 203",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731312",
            "telephone_number": "732-563-0033",
            "fax_number": "732-563-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERIASAMY",
        "first_name": "JAYANTHI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA07322300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.