Individual provider Active NPI

Akshaya Jitendra Vachharajani, MD

  • Neonatal-Perinatal Medicine Physician
  • Columbia, MO
National Provider Identifier
1164448395
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
2004001489 Issued in MO
Practice address
404 N Keene St
Columbia, MO 65201-6626
Phone
(573) 875-9000
Fax
(573) 884-1795
NPI assigned
Jul 14, 2006
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2004001489 MO
Neonatal-Perinatal Medicine Physician 2080N0001X 2004001489 MO Primary

Addresses

Primary practice location

404 N Keene St
Columbia, MO 65201-6626

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other identifiers 2

IdentifierTypeStateIssuer
206143901MedicaidMO
ENROLLEDMedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20041124000602 MO Practitioner - Pediatric MedicinePractitioner - Emergency MedicinePractitioner - Other (Physician) 5698730075 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jun 25, 2010 Accepting new patients
The Curators of the University of Missouri CurrentSince Dec 17, 2018 Accepting new patients
Curators of the University of Missouri CurrentSince Dec 17, 2018 Accepting new patients
Washington University CurrentSince Jun 25, 2010 Accepting new patients
Curators of the University of Missouri Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

404 N Keene St
Columbia, MO 65201
Phone (573) 875-9000

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

1 Childrens Pl
#8116
Saint Louis, MO 63110
Phone (314) 454-6095

1 Childrens Pl
Ste 5S20
Saint Louis, MO 63110

1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1664928000000",
    "number": "1164448395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-875-9000",
            "fax_number": "573-884-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHHARAJANI",
        "first_name": "AKSHAYA",
        "middle_name": "JITENDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-10-05",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2004001489",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MO",
            "license": "2004001489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206143901",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT",
            "address_1": "1 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.