NPIMap

Individual provider Active NPI

Umamaheswara Rao Vejendla Physician PC

  • Internal Medicine Physician
  • Jamestown, NY
National Provider Identifier
1053429829
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
214279-1 Issued in NY
Practice address
152 Foote Ave
Jamestown, NY 14701-6940
Phone
(716) 664-5290
Fax
(716) 664-7630
NPI assigned
Aug 29, 2006
Last updated
May 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 214279-1 NY Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2142791 NY

Addresses

Primary practice location

152 Foote Ave
Jamestown, NY 14701-6940

Mailing address

152 Foote Ave
Jamestown, NY 14701-6940
Phone (716) 664-5290

Other identifiers 7

IdentifierTypeStateIssuer
02050080MedicaidNY
0410963OtherNYINDEPENDENT HEALTH
525874001OtherNYBLUE CROSS
21017301OtherNYUNIVERA
52060000OtherNYUNIVERA SR. SHOICE
161070314OtherNYNOVA
040426003867OtherNYFIDELIS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000012 NY Practitioner - Internal Medicine 3476514134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umamaheswara Rao Vejendla Physician PCGroup PAC ID 9133180888, 4 clinicians

Practice addresses (Care Compare)

152 Foote Ave
Jamestown, NY 14701-6940
Phone 7166645290208

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2142791NYMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Chautauqua at Wca Past Accepting new patients
Upmc Chautauqua at Wca Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: drvejendla@vejendla.medentdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1053429829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016940",
            "telephone_number": "716-664-5290",
            "fax_number": "716-664-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016940",
            "telephone_number": "716-664-5290",
            "fax_number": "716-664-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEJENDLA PHYSICIAN PC",
        "first_name": "UMAMAHESWARA",
        "middle_name": "RAO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214279-1",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "2142791",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02050080",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0410963",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "525874001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "21017301",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA SR. SHOICE",
            "identifier": "52060000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVA",
            "identifier": "161070314",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426003867",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.