Vasantha Kondamudi, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA06681100 Issued in NJ

Practice address

718 Teaneck Rd
Teaneck, NJ 07666-4245

Phone

(201) 833-3000

NPI assigned

Aug 4, 2006

Last updated

Apr 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Specialty

Family PracticeAlso: Geriatric Medicine

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vkondamudi8932@prd.direct.tbh.org

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• The Brooklyn Hospital Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1326046467

  Corporate Director

  CMS ownership
• The Brooklyn Hospital Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1790719524

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Excelcare Medical Associates, PA

  • Internal Medicine Physician
  • Teaneck, NJ
  • NPI 1992736300

  Family Medicine

  Medicare reassignment Care Compare group NPD
• TBHC Medical Services PC

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1508959743
  Medicare reassignment NPD
• Holy Name Primary Care and Specialty Associates, PC

  • Psychiatry Physician
  • Teaneck, NJ
  • NPI 1104256130
  Authorized official Same address or phone
• Clenton Coleman MD PC

  • Nephrology Physician
  • Teaneck, NJ
  • NPI 1801125265
  NPD (past)
• Holy Name Cardiology Associates, PC

  • Cardiovascular Disease Physician
  • Teaneck, NJ
  • NPI 1710168232
  NPD (past)
• Holy Name Health Physicians

  • Internal Medicine Physician
  • Teaneck, NJ
  • NPI 1194395269

  Family Medicine

  NPD (past)
• Caledonian Health Center

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1184657355
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1144238924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLZ STE 205",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016208",
            "telephone_number": "201-833-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "201-833-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDAMUDI",
        "first_name": "VASANTHA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "205727",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA06681100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01841556",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lea Kobayashi-Moore, L.C.S.W.
• Sara Kohanim, DPT
• Ayelet Kohenbash
• Robert S Kolatac, DMD
• Neil Harris Kolsky, MD
• Kamol Kongtong, BSCE
• Gen Koshibe, M.D.
• Roman Kostyk
• Walae Kourani, PHARMD
• Yocheved Kramer, PA

• Family Medicine Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.