Individual provider Active NPI

Narasimhaloo Venugopal, MD

  • Internal Medicine Physician
  • Vineland, NJ
National Provider Identifier
1093883316
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA02825000 Issued in NJ
Practice address
1100 E Chestnut Ave
Vineland, NJ 08360-5002
Phone
(856) 696-0108
Fax
(856) 696-0188
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA02825000 NJ Primary

Addresses

Primary practice location

1100 E Chestnut Ave
Vineland, NJ 08360-5002

Mailing address

76 S State St
Vineland, NJ 08360-4851
Phone (856) 205-1112

Other identifiers 1

IdentifierTypeStateIssuer
2875501MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20060113000713 NJ Practitioner - Internal Medicine 6002830296 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Alliance, LLC Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
Dendrinos Medical Associates, P.a. Past Accepting new patients

Locations

2020 E Chestnut Ave
Vineland, NJ 08361
Phone (856) 563-1600

1100 E Chestnut Ave
Vineland, NJ 08360
Phone (609) 696-0108

76 S State St
Vineland, NJ 08360
Phone (856) 205-1112

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12810/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1093883316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 S STATE ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604851",
            "telephone_number": "856-205-1112",
            "fax_number": "856-205-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605002",
            "telephone_number": "856-696-0108",
            "fax_number": "856-696-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENUGOPAL",
        "first_name": "NARASIMHALOO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA02825000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2875501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.