Organization Active NPI

Umamaheswara Rao Vejendla Physician PC

  • Internal Medicine Physician
  • Jamestown, NY
National Provider Identifier
1407074057
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UMAMAHESWARA RAO VEJENDLA PHYSICIAN PC
Practice address
152 Foote Avenue
Jamestown, NY 14701
Phone
(716) 664-5290
NPI assigned
Apr 20, 2007
Last updated
Sep 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Authorized official

Name
Umamaheswara Vejendla, M.D.
Title
Ceo
Phone
(716) 664-5290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

152 Foote Avenue
Jamestown, NY 14701

Mailing address

152 Foote Avenue
Jamestown, NY 14701
Phone (716) 664-5290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041026000082 NY Part B Supplier - Clinic/Group Practice 9133180888 Receives reassigned benefits from 5 practitioners
Practice locations: Jamestown, NY

National Provider Directory

National Provider Directory

Locations

152 Foote Ave
Jamestown, NY 14701
Phone (716) 664-3325

Practitioners & affiliated clinicians

Practitioners 5

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": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1407074057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 FOOTE AVENUE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "14701",
            "telephone_number": "716-664-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 FOOTE AVENUE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "14701",
            "telephone_number": "716-664-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMAMAHESWARA RAO VEJENDLA PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "VEJENDLA",
        "authorized_official_first_name": "UMAMAHESWARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "716-664-5290",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.