NPIMap

Individual provider Active NPI

Rejeesh Vijaya Vasudev, M.D.

  • Nephrology Physician
  • Bryan, TX
National Provider Identifier
1083807937
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
P1705 Issued in TX
Practice address
2110 E Villa Maria Rd
Bryan, TX 77802-2542
Phone
(979) 822-5555
NPI assigned
Aug 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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 P1705 TX Primary

Addresses

Primary practice location

2110 E Villa Maria Rd
Bryan, TX 77802-2542

Mailing address

2110 E Villa Maria Rd
Bryan, TX 77802-2542
Phone (979) 822-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120723000438 TX Practitioner - NeurologyPractitioner - Internal MedicinePractitioner - Nephrology 1658537501 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Kidney Center PLLCGroup PAC ID 6901950740, 2 clinicians

Practice addresses (Care Compare)

2110 E Villa Maria Rd
Bryan, TX 77802-2542
Phone (979) 822-5555

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Kidney Center PLLC CurrentSince Jul 1, 2012 Accepting new patients
Rejeesh Vasudev MD PA Nephrology CurrentSince Feb 25, 2020 Accepting new patients
Cogent Healthcare of Texas, PA Family Medicine CurrentSince Feb 5, 2020 Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

2110 E Villa Maria Rd
Bryan, TX 77802
Phone (979) 402-3152

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1083807937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022542",
            "telephone_number": "979-822-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022542",
            "telephone_number": "979-822-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASUDEV",
        "first_name": "REJEESH",
        "middle_name": "VIJAYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "P1705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.