Individual provider Active NPI

Vijaya Vemulakonda, MD

  • Pediatric Urology Physician
  • Charlottesville, VA
National Provider Identifier
1093826976
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
License
0101286111 Issued in VA
Practice address
1204 W Main St
Charlottesville, VA 22903-2824
Phone
(434) 924-0123
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101286111 VA
Pediatric Urology Physician 2088P0231X 48967 CO
Pediatric Urology Physician 2088P0231X 0101286111 VA Primary

Addresses

Primary practice location

1204 W Main St
Charlottesville, VA 22903-2824

Mailing address

PO Box 749112
Atlanta, GA 30374-9112

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Other practice location 2

1215 Lee St
Charlottesville, VA 22908-7106
Phone (434) 924-3627

Other identifiers 1

IdentifierTypeStateIssuer
16052749MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250627002289 VA Practitioner - UrologyPractitioner - Pediatric Medicine 3971603606 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101286111VAMDUrology Physician
48967COMDPediatric Urology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jul 25, 2025 Accepting new patients
Washington University Past Accepting new patients
F Read Hopkins Pediatric Assoc Inc Past Accepting new patients

Locations

1204 W Main St
Charlottesville, VA 22903
Phone (434) 924-0123

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1212 McConville Rd
Lynchburg, VA 24502
Phone (434) 237-8886

Interoperability endpoints

  • Direct secure messaging: vvemulakonda680974@direct.healthsystem.virginia.edu

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1093826976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W MAIN ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032824",
            "telephone_number": "434-924-0123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229087106",
            "country_code": "US",
            "telephone_number": "434-924-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEMULAKONDA",
        "first_name": "VIJAYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101286111",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "CO",
            "license": "48967",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "VA",
            "license": "0101286111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16052749",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.