Active NPI
Jonathan Ramesh Vamadeva, DO
- Sports Medicine (Internal Medicine) Physician
- Wayne, NJ
National Provider Identifier
1063152197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Internal Medicine) Physician
- License
- 25MB12720800
- Practice address
- 504 Valley Rd Ste 201
Wayne, NJ 07470-3534 - Phone
- (973) 446-7500
- Fax
- (973) 554-4922
- NPI assigned
- Mar 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | 25MB12720800 | NJ | Primary |
Addresses
Primary practice location
504 Valley Rd Ste 201
Wayne, NJ 07470-3534
Mailing address
504 Valley Rd Ste 201
Wayne, NJ 07470-3534
Phone (973) 446-7500
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241022002732 | PA | Order and Referring Only - Internal Medicine | 4688106149 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB12720800 | NJ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784851200000",
"number": "1063152197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 VALLEY RD STE 201",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074703534",
"telephone_number": "973-446-7500",
"fax_number": "973-554-4922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 VALLEY RD STE 201",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074703534",
"telephone_number": "973-446-7500",
"fax_number": "973-554-4922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAMADEVA",
"first_name": "JONATHAN",
"middle_name": "RAMESH",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-29",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RS0010X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sports Medicine",
"state": "NJ",
"license": "25MB12720800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.