Individual provider Active NPI

Vikramaditya Dulam, M.D.

  • Cardiovascular Disease Physician
  • Natchez, MS
National Provider Identifier
1194767806
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
18344 Issued in MS
Practice address
140 Jefferson Davis Blvd
Natchez, MS 39120-5104
Phone
(601) 304-9718
Fax
(601) 304-9637
NPI assigned
Jun 10, 2006
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 18344 MS Primary

Addresses

Primary practice location

140 Jefferson Davis Blvd
Natchez, MS 39120-5104

Mailing address

140 Jefferson Davis Blvd
Natchez, MS 39120-5104
Phone (601) 304-9718

Other identifiers 2

IdentifierTypeStateIssuer
02602371MedicaidMS
1197785OtherLOUISIANA MEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 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

Enrollment IDStateProvider typePAC IDDetails
I20040818001091 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7618940446 Reassigns benefits to 3 organizations
Practice locations: Natchez, MS
I20091109000030 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7618940446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

140 Jeff Davis Blvd
Natchez, MS 39120-5104
Phone 6013049718107

209 Front St
Vidalia, LA 71373-2837
Phone (318) 336-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.4 of 100Reported as individual
Quality
83.1
Improvement activities
40
Cost
30.84

Merit-based Incentive Payment System (MIPS)

Final score
82.53 of 100Reported as group
Quality
69.43
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18344MSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concordia Parish Hospital Service District Number One CurrentSince Aug 30, 2011 Accepting new patients
Concordia Parish Hospital Service District Number One Current Accepting new patients
Concordia Parish Hospital Service District Number One CurrentSince Aug 30, 2011 Accepting new patients
Natchez HBP Services LLC CurrentSince Oct 1, 2014 Accepting new patients
Dr Rao Velaga PSC Cardiovascular Disease Past Accepting new patients
Natchez Hma Physician Management LLC Past Accepting new patients

Locations

6569 Highway 84
Ridgecrest, LA 71334
Phone 3187576551605

54 Sgt Prentiss Dr
Natchez, MS 39120
Phone (601) 443-2100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20491/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1194767806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 JEFFERSON DAVIS BLVD",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391205104",
            "telephone_number": "601-304-9718",
            "fax_number": "601-304-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 JEFFERSON DAVIS BLVD",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391205104",
            "telephone_number": "601-304-9718",
            "fax_number": "601-304-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULAM",
        "first_name": "VIKRAMADITYA",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "18344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02602371",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA MEDICAID",
            "identifier": "1197785",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchez, MS

Sources for this page

Verify at the official NPI Registry.