Individual provider Active NPI

Divya Vundamati, MD

  • Internal Medicine Physician
  • Madison, WI
National Provider Identifier
1184365330
Registry record updated Mar 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
83379 Issued in WI
Practice address
749 University Row Ste 200
Madison, WI 53705-1465
Phone
(608) 263-6400
NPI assigned
Apr 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 83379 WI Primary

Addresses

Primary practice location

749 University Row Ste 200
Madison, WI 53705-1465

Mailing address

749 University Row Ste 200
Madison, WI 53705-1465
Phone (608) 263-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220708002460 WI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1658751508

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83379WIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1648944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710028800000",
    "number": "1184365330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 UNIVERSITY ROW STE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537051465",
            "telephone_number": "608-263-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 UNIVERSITY ROW STE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537051465",
            "telephone_number": "608-263-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUNDAMATI",
        "first_name": "DIVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-03",
        "last_updated": "2024-03-10",
        "certification_date": "2024-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "83379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.