Organization Active NPI

Vineland Medical Associates PA

  • Internal Medicine Physician
  • Vineland, NJ
National Provider Identifier
1316943111
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06727800 Issued in NJ
Legal business name
VINELAND MEDICAL ASSOCIATES PA
Practice address
1100 E Chestnut Ave
Vineland, NJ 08360-5002
Phone
(856) 696-0108
Fax
(856) 691-1106
NPI assigned
Jun 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Narasimhaloo Venugopal, M.D.NPI 1093883316
Title
President
Phone
(856) 696-0108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA06727800 NJ Primary

Addresses

Primary practice location

1100 E Chestnut Ave
Vineland, NJ 08360-5002

Mailing address

1100 E Chestnut Ave
Vineland, NJ 08360-5002
Phone (856) 696-0108

Other identifiers 1

IdentifierTypeStateIssuer
8193100MedicaidNJ

National Provider Directory

National Provider Directory

Locations

1100 E Chestnut Ave
Vineland, NJ 08360
Phone (609) 696-0108

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316943111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605002",
            "telephone_number": "856-696-0108",
            "fax_number": "856-691-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605002",
            "telephone_number": "856-696-0108",
            "fax_number": "856-691-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINELAND MEDICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VENUGOPAL",
        "authorized_official_first_name": "NARASIMHALOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-696-0108",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06727800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8193100",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.