Individual provider Active NPI

Vijayabharathi Ekambaram, MD

  • Psychiatry Physician
  • Pensacola, FL
National Provider Identifier
1093000689
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME164700 Issued in FL
Practice address
2191 E Johnson Ave
Pensacola, FL 32514-6029
Phone
(850) 494-3953
Fax
(850) 494-3960
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME164700 FL Primary

Addresses

Primary practice location

2191 E Johnson Ave
Pensacola, FL 32514-6029

Mailing address

2191 E Johnson Ave
Pensacola, FL 32514-6029
Phone (850) 494-3953

Other names 1

  • Vijaya Ekambaram Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231115000115 FL Practitioner - Psychiatry 6305129552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Behavioral Health IncGroup PAC ID 9537126222, 16 clinicians

Practice addresses (Care Compare)

2191 E Johnson Ave
Pensacola, FL 32514-6039
Phone (850) 494-3953

Hospital & facility affiliations

  • HCA Florida West Hospital Hospital, Pensacola, FL, CCN 100231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME164700FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Behavioral Health Inc CurrentSince Nov 1, 2023 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

2191 E Johnson Ave
Pensacola, FL 32514
Phone (850) 474-8360

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: vijayabharathi.ekambaram@hca5.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1093000689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 E JOHNSON AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146029",
            "telephone_number": "850-494-3953",
            "fax_number": "850-494-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 E JOHNSON AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146029",
            "telephone_number": "850-494-3953",
            "fax_number": "850-494-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKAMBARAM",
        "first_name": "VIJAYABHARATHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME164700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIJAYA",
            "last_name": "EKAMBARAM",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.