Active NPI
Chanda Bradshaw, M.D.
- Pediatrics Physician
- Plainsboro, NJ
National Provider Identifier
1962677971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA028964400
- Practice address
- 1 Plainsboro Rd
Chop Care Network at Princeton Medical Center
Plainsboro, NJ 08536-1913 - Phone
- (609) 853-7000
- Fax
- (609) 497-4173
- NPI assigned
- Apr 30, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MT192486 | PA | |
| Pediatrics Physician | 208000000X | 25MA028964400 | NJ | Primary |
Addresses
Primary practice location
1 Plainsboro Rd
Chop Care Network at Princeton Medical Center
Plainsboro, NJ 08536-1913
Mailing address
100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9234
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cbradshaw80608@nyumc.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA028964400 | NJ | MD | Pediatrics Physician |
| MT192486 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Pediatrics | Current | Accepting new patients |
| New York University | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Past | Accepting new patients | |
| NYU Langone Hospitals | Past | Accepting new patients |
Locations
550 1st Ave
New York, NY 10016
Phone (212) 263-3293
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- cbradshaw673155@nychhc.direct-ci.com
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY, Pediatrics
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- General Acute Care Hospital
- New York, NY
- NPI 1073535027
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1962677971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E PENN SQ",
"address_2": "9TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191073323",
"telephone_number": "267-425-9234",
"fax_number": "267-425-9299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PLAINSBORO RD",
"address_2": "CHOP CARE NETWORK AT PRINCETON MEDICAL CENTER",
"city": "PLAINSBORO",
"state": "NJ",
"postal_code": "085361913",
"telephone_number": "609-853-7000",
"fax_number": "609-497-4173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "CHANDA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-30",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MT192486",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA028964400",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cbradshaw80608@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "550 1st Ave",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100166402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Plainsboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.