Individual provider Active NPI

Mary Vajravelu, M.D.

  • Pediatric Endocrinology Physician
  • Pittsburgh, PA
National Provider Identifier
1083977342
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
MD454379 Issued in PA
Practice address
4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone
(412) 692-5170
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT201169 PA
Pediatric Endocrinology Physician 2080P0205X MD454379 PA Primary

Addresses

Primary practice location

4401 Penn Ave
Pittsburgh, PA 15224-1334

Mailing address

4401 Penn Ave
Faculty Pavilion 6TH Floor
Pittsburgh, PA 15224
Phone (412) 692-5170

Other identifiers 1

IdentifierTypeStateIssuer
1034873410002MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chp@upmcdirect.com Health Information Exchange (HIE)

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
I20180522001570 PA Practitioner - Pediatric MedicinePractitioner - Endocrinology 7719242718 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Endocrinology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone (412) 692-9513

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT201169PAMDPediatrics Physician
MD454379PAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childen'S Health Care Associates Inc. CurrentSince May 1, 2018 Accepting new patients
University of Pittsburgh Physicians Pediatrics CurrentSince Jul 1, 2021 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2021 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Childrens Health Care Associates, Inc Pediatric Endocrinology CurrentSince May 1, 2018 Accepting new patients
Upmc Children'S Hospital of Pittsburgh Past Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

4401 Penn Ave
Fl 6
Pittsburgh, PA 15224
Phone (412) 692-5180

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

Interoperability endpoints

  • Direct secure messaging: chp@upmcdirect.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1083977342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 PENN AVE",
            "address_2": "FACULTY PAVILION 6TH FLOOR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15224",
            "telephone_number": "412-692-5170",
            "fax_number": "412-692-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241334",
            "telephone_number": "412-692-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAJRAVELU",
        "first_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2021-08-19",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT201169",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "PA",
            "license": "MD454379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034873410002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chp@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4401 Penn Ave",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152241334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.