Active NPI
Vishaka Chetram
- Cardiovascular Disease Physician
- Fairfax, VA
National Provider Identifier
1134745375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 83037
- Practice address
- 3300 Gallows Rd
Fairfax, VA 22031 - Phone
- (703) 776-4001
- NPI assigned
- Jun 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Cardiovascular Disease Physician | 207RC0000X | 83037 | CT | Primary |
Addresses
Primary practice location
3300 Gallows Rd
Fairfax, VA 22031
Mailing address
3300 Gallows Rd
Fairfax, VA 22031
Phone (703) 776-4001
Other practice location 1
15 Riverside Ave
Bristol, CT 06010-6312
Phone (860) 582-3235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Bristol, CT 06011
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83037 | CT | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779235200000",
"number": "1134745375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 GALLOWS RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "22031",
"telephone_number": "703-776-4001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 GALLOWS RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "22031",
"telephone_number": "703-776-4001"
}
],
"practiceLocations": [
{
"address_1": "15 Riverside Ave",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "CT",
"postal_code": "060106312",
"country_code": "US",
"telephone_number": "860-582-3235",
"fax_number": "860-582-3235",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHETRAM",
"first_name": "VISHAKA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-23",
"last_updated": "2026-05-20",
"certification_date": "2026-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CT",
"license": "83037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.