Individual provider Active NPI

Indu N Vira, MD

  • Internal Medicine Physician
  • East Orange, NJ
National Provider Identifier
1013962968
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03992300 Issued in NJ
Practice address
60 Evergreen Place
Suite 400
East Orange, NJ 07018
Phone
(973) 395-1550
Fax
(973) 395-1556
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA03992300 NJ Primary

Addresses

Primary practice location

60 Evergreen Place
Suite 400
East Orange, NJ 07018

Mailing address

751 S Middlesex Ave
Colonia, NJ 07067-3718
Phone (732) 499-9835

Other identifiers 1

IdentifierTypeStateIssuer
0780804MedicaidNJ

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
I20060112000367 NJ Practitioner - Internal Medicine 2466475702 Reassigns benefits to 1 organization
Practice locations: Newark, NJ

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Nurse Association of Central Jersey Community Health Center I CurrentSince Mar 18, 2019 Accepting new patients
Visiting Nurse Association of Central Jersey Community Health Center I CurrentSince Mar 18, 2019 Accepting new patients
Visiting Nurse Association of Central Jersey Community Health Center I Current Accepting new patients
Naspac1 LLC PastSince Sep 1, 2024 Accepting new patients

Locations

1301 Main St
Asbury Park, NJ 07712
Phone (732) 774-6333

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1013962968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S MIDDLESEX AVE",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070673718",
            "telephone_number": "732-499-9835",
            "fax_number": "973-374-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 EVERGREEN PLACE",
            "address_2": "SUITE 400",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "07018",
            "telephone_number": "973-395-1550",
            "fax_number": "973-395-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRA",
        "first_name": "INDU",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03992300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0780804",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.