Individual provider Active NPI

Vijay Sridhar Karajala-Subramanyam

  • Internal Medicine Physician
  • Media, PA
National Provider Identifier
1033243480
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD427320 Issued in PA
Practice address
1068 W Baltimore Pike
Media, PA 19063-5104
Phone
(484) 227-4216
Fax
(484) 227-4230
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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 MD427320 PA Primary

Addresses

Primary practice location

1068 W Baltimore Pike
Media, PA 19063-5104

Mailing address

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (484) 227-4216

Other identifiers 1

IdentifierTypeStateIssuer
232359401OtherPAMAIN LINE HEALTHCARE TAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080324000402 PA Practitioner - Internal Medicine 7517043110 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450

1033 W Germantown Pike Valley Forge M
Norristown, PA 19403-3905
Phone (732) 886-6202

255 W Lancaster Ave
Paoli, PA 19301-1763

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avenues Recovery Medical Center at Valley Forge CurrentSince Aug 13, 2024 Accepting new patients
Avenues Recovery Medical Center at Valley Forge CurrentSince Aug 13, 2024 Accepting new patients
Suburban Medical Group LLC Internal Medicine CurrentSince Feb 1, 2016 Accepting new patients
Inhospital Physicians Corp Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Main Line Healthcare Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Main Line Hospitals, Inc. Past Accepting new patients

Locations

850 Towbin Ave
Lakewood, NJ 08701
Phone (732) 886-6202

610 Sentry Pkwy
Bldg 660
Blue Bell, PA 19422

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

2701 DeKalb Pike
Fl 2
East Norriton, PA 19401
Phone (610) 275-1028

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

1033 W Germantown Pike
Norristown, PA 19403
Phone (610) 539-8500

2701 DeKalb Pike
Norristown, PA 19401
Phone (215) 335-6000

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1033243480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635104",
            "telephone_number": "484-227-4216",
            "fax_number": "484-227-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635104",
            "telephone_number": "484-227-4216",
            "fax_number": "484-227-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARAJALA-SUBRAMANYAM",
        "first_name": "VIJAY",
        "middle_name": "SRIDHAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD427320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIN LINE HEALTHCARE TAX ID",
            "identifier": "232359401",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.