Individual provider Active NPI

Vindhya Lakshmi Veerula, MD

  • Dermatology Physician
  • Indianapolis, IN
National Provider Identifier
1104180793
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
11016587A Issued in IN
Practice address
1001 W 10TH St # M200
Indianapolis, IN 46202-2859
Phone
(317) 656-4260
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 11016587A IN Primary

Addresses

Primary practice location

1001 W 10TH St # M200
Indianapolis, IN 46202-2859

Mailing address

1001 W 10TH St # M200
Indianapolis, IN 46202-2859
Phone (317) 656-4260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160831001328 IN Practitioner - Dermatology 9931340767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Northeastern Ohio University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Park Pediatrics P CGroup PAC ID 2961748991, 4 clinicians

Practice addresses (Care Compare)

3919 W Jefferson Blvd
Suite 1
Fort Wayne, IN 46804-6811
Phone (260) 436-7722

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions61
Removal or shaving of skin growth27
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Park Pediatrics P C Dermatology CurrentSince Dec 17, 2018 Accepting new patients
Jefferson Pediatrics, PC PastSince Dec 17, 2018 Accepting new patients

Locations

3919 W Jefferson Blvd
Ste 2
Fort Wayne, IN 46804
Phone (260) 436-7722

7802 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-7000

3919 W Jefferson Blvd
Ste 1
Fort Wayne, IN 46804
Phone (260) 436-7722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHJJCD/Endpoint/AHJJCD

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1104180793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W 10TH ST # M200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022859",
            "telephone_number": "317-656-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W 10TH ST # M200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022859",
            "telephone_number": "317-656-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEERULA",
        "first_name": "VINDHYA",
        "middle_name": "LAKSHMI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "11016587A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.