Individual provider Active NPI

Vellore Padmanaban Jayakrishnan, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1386745867
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
128925 Issued in NY
Practice address
355 Ovington Ave
Suite 203
Brooklyn, NY 11209-1459
Phone
(718) 748-4871
Fax
(718) 833-3940
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 128925 NY Primary

Addresses

Primary practice location

355 Ovington Ave
Suite 203
Brooklyn, NY 11209-1459

Mailing address

355 Ovington Ave
Suite 203
Brooklyn, NY 11209-1459
Phone (718) 748-4871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
128925NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386745867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 OVINGTON AVE",
            "address_2": "SUITE 203",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091459",
            "telephone_number": "718-748-4871",
            "fax_number": "718-833-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 OVINGTON AVE",
            "address_2": "SUITE 203",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091459",
            "telephone_number": "718-748-4871",
            "fax_number": "718-833-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYAKRISHNAN",
        "first_name": "VELLORE",
        "middle_name": "PADMANABAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "128925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.