Individual provider Active NPI

Vishwaarth Vijayakumar

  • Student in an Organized Health Care Education/Training Program
  • Urbana, IL
National Provider Identifier
1184482580
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
506 S Mathews Ave
Urbana, IL 61801-3618
Phone
(217) 300-5700
NPI assigned
Mar 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

506 S Mathews Ave
Urbana, IL 61801-3618

Mailing address

506 S Mathews Ave
Urbana, IL 61801-3618

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
I20250804002822 MO Order and Referring Only - General SurgeryPractitioner - General Surgery 8527576206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1184482580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S MATHEWS AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618013618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 S MATHEWS AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618013618",
            "telephone_number": "217-300-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYAKUMAR",
        "first_name": "VISHWAARTH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.