Individual provider Active NPI

Vijay M. Rao, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1124044003
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD036039L Issued in PA
Practice address
111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone
(215) 955-6226
Fax
(215) 923-1562
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X MD036039L PA
Diagnostic Radiology Physician 2085R0202X MD036039L PA Primary

Addresses

Primary practice location

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Mailing address

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Other identifiers 2

IdentifierTypeStateIssuer
2395401MedicaidNJ
000708624MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040311000841 PA Practitioner - Diagnostic Radiology 3274422969 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD036039LPAMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince May 20, 2010 Accepting new patients
Jefferson University Radiology Associates LLC Diagnostic Radiology CurrentSince May 20, 2010 Accepting new patients
800 Imaging Associates LLC CurrentSince Jan 21, 2021 Accepting new patients
Jeanes Radiology Associates LLC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Rittenhouse Imaging Center, LLC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Lebanon Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Jun 10, 2021 Accepting new patients
Imaging Professionals of Pennsylvania PC Diagnostic Radiology Past Accepting new patients
Imaging Associates, PA Past Accepting new patients
Insight Health Corp PastSince Jun 10, 2021 Accepting new patients

Locations

462 Gateway Ave
Chambersburg, PA 17201
Phone (717) 263-4999

150 E Pennsylvania Ave
Downingtown, PA 19335
Phone (215) 772-9674

800 W State St
Ste 203
Doylestown, PA 18901
Phone (215) 345-4568

825 Town Center Dr
Ste 100
Langhorne, PA 19047
Phone (215) 750-1615

1 W Germantown Pike
Norristown, PA 19401
Phone (610) 277-3202

850 Walnut St
Philadelphia, PA 19107
Phone (215) 503-4900

301 Callowhill St
Philadelphia, PA 19123
Phone (215) 574-9400

Organizations & group practices 10

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1124044003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6226",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "VIJAY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "MD036039L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD036039L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2395401",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000708624",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.