Individual provider Active NPI

Vettaikorumakankav V Vedanarayanan, MD, FRCPC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Austin, TX
National Provider Identifier
1174565469
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
S6321 Issued in TX
Practice address
4910 Mueller Blvd.
Suite 300
Austin, TX 78723
Phone
(512) 628-1855
Fax
(512) 380-7544
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 12953 MS
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 12953 MS
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X S6321 TX Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X S6321 TX
Pediatrics Physician 208000000X 12953 MS
Pediatrics Physician 208000000X S6321 TX

Addresses

Primary practice location

4910 Mueller Blvd.
Suite 300
Austin, TX 78723

Mailing address

4910 Mueller Blvd
Suite 300
Austin, TX 78723
Phone (512) 628-1855

Other identifiers 5

IdentifierTypeStateIssuer
P01234014OtherMSRAILROAD MEDICARE PTAN
1982156MedicaidLA
155977MedicaidAL
PTAN P00462340OtherMSRR MEDICARE
00019355MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20201015000029 TX Practitioner - Neurology 4486738564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dell Childrens Medical GroupGroup PAC ID 8224092978, 117 clinicians

Practice addresses (Care Compare)

1301 Barbara Jordan Blvd
Suite 200
Austin, TX 78723-3078
Phone (512) 628-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12953MSMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group Pediatrics CurrentSince Sep 1, 2020 Accepting new patients
Dell Children'S Medical Group CurrentSince Sep 1, 2020 Accepting new patients
Dell Children'S Medical Group Pediatrics Current Accepting new patients
University Neurology Group, PLLC Past Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4910 Mueller Blvd
Ste 300
Austin, TX 78723
Phone (512) 324-0907

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: vettaikorumakankav.vedanarayanan.1@8363.direct.athenahealth.com

Organizations & group practices 4

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1174565469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 MUELLER BLVD",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78723",
            "telephone_number": "512-628-1855",
            "fax_number": "512-380-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 MUELLER BLVD.",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78723",
            "telephone_number": "512-628-1855",
            "fax_number": "512-380-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDANARAYANAN",
        "first_name": "VETTAIKORUMAKANKAV",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "MD, FRCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MS",
            "license": "12953",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MS",
            "license": "12953",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "S6321",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "S6321",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "12953",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S6321",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01234014",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982156",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155977",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "PTAN P00462340",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00019355",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.