Active NPI
Vidya Menon, MD
- Internal Medicine Physician
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00038309
- Practice address
- 1717 S J St
Tacoma, WA 98405-4933 - Phone
- (253) 426-6341
- Fax
- (253) 426-6344
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00038309 | WA | Primary |
Addresses
Primary practice location
1717 S J St
Tacoma, WA 98405-4933
Mailing address
1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8268534 | Medicaid | WA | |
| P00335363 | Other | WA | RAILROAD |
| 0191507 | Other | WA | STATE L&I |
| 8939543 | Other | WA | STATE CRIME VICTIMS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
234 E 149 St
Bronx, NY 10451-5504
Phone (718) 579-6101
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Affiliate Group of New York PC | Current | Accepting new patients | |
| Downtown Bronx Medical Associates PC | Current | Accepting new patients | |
| Okanogan Douglas County Hospital Dist 1 | Past | Accepting new patients | |
| New York City Health and Hospitals Corporation | Internal Medicine | Past | Accepting new patients |
| Munoz Regimbal and Associates Physicians Professional LLC | Past | Accepting new patients |
Locations
234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874
2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Interoperability endpoints
- vmenon847205@nychhc.direct-ci.com
Organizations & group practices 5
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.
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bronx, NY
- NPI 1689618407
-
dba Internal Medicine Northwest
- Specialist
- Tacoma, WA
- NPI 1356388276
-
dba Advantage D.M.E.
- Critical Access Hospital
- Brewster, WA
- NPI 1508911645
-
dba Lincoln Medical And Mental Health Center
- General Acute Care Hospital
- Bronx, NY
- NPI 1427063270
Internal Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Lincoln Medical And Mental Health Center
- General Acute Care Hospital
- Bronx, NY
- NPI 1427063270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289865600000",
"number": "1114011285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 S J ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054933",
"telephone_number": "253-426-6341",
"fax_number": "253-426-6344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S J ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054933",
"telephone_number": "253-426-6341",
"fax_number": "253-426-6344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENON",
"first_name": "VIDYA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2010-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00038309",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8268534",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00335363",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "0191507",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE CRIME VICTIMS",
"identifier": "8939543",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.