Ketaki Vaidhyanathan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA08170600 Issued in NJ

Practice address

1 Bay Ave
Montclair, NJ 07042-4837

Phone

(973) 429-6260

NPI assigned

Jul 15, 2007

Last updated

Aug 3, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Rutgers New Jersey Medical School, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Josephs Healthcare IncGroup PAC ID 9739171984, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvaidhyanathan@sjhbh.cernerdirect.com

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.

• St. Joseph's Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  Medicare reassignment Care Compare group NPD
• Montclair Hospital LLC

  dba Outpatient Behavioral Health Department

  • Adult Mental Health Clinic/Center
  • Montclair, NJ
  • NPI 1386893659

  Psychiatry

  Medicare reassignment NPD
• St Josephs Medical Group PC

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1205425519
  Medicare reassignment NPD
• Montclair Hospital LLC

  dba HackensackUMC Mountainside

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  NPD
• St Josephs University Medical Center Inc.

  dba St. Joseph's University Medical Center Specialty Pharmacy

  • Community/Retail Pharmacy
  • Paterson, NJ
  • NPI 1477304541
  NPD (past)

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

• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1184457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1992904445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 ROMAINE AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071948",
            "telephone_number": "201-845-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDHYANATHAN",
        "first_name": "KETAKI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-15",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA08170600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0232084",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• United Surgical Assists LLC
• United Woundcare Institute PC
• Universal Counseling LLC
• Upper Montclair Eye Care & Wear LLC
• Frances Adele Vadas, LCSW
• John-Eric Vallarta, CRNA
• Ann Frances Vallone, NURSE PRACTITIONER
• Franz Emmanuelle Valmores, MD
• Van Dyk Healthcare, Inc.
• Peggy Van Raalte, PSY.D

• Psychiatry Physician in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.