NPIMap

Individual provider Active NPI

Vijayalakshmi Wijeyakumar, M.D.

  • Nephrology Physician
  • Fountain Valley, CA
National Provider Identifier
1053491332
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A49216 Issued in CA
Practice address
11100 Warner Ave
Suite 212
Fountain Valley, CA 92708-7506
Phone
(714) 641-9696
Fax
(714) 641-1211
NPI assigned
Oct 17, 2006
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A49216 CA Primary

Addresses

Primary practice location

11100 Warner Ave
Suite 212
Fountain Valley, CA 92708-7506

Mailing address

4225 Executive SQ Ste 450
La Jolla, CA 92037-8411
Phone (858) 810-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A49216CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alta Newport Hospital, LLC Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients
Victor Valley Community Hospital Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1053491332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ STE 450",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920378411",
            "telephone_number": "858-810-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 212",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-641-9696",
            "fax_number": "714-641-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJEYAKUMAR",
        "first_name": "VIJAYALAKSHMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A49216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.