Individual provider Active NPI

Vishakha Sirpal

  • Internal Medicine Physician
  • Long Branch, NJ
National Provider Identifier
1417566134
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101281326 Issued in VA
Practice address
300 2ND Ave
Long Branch, NJ 07740-6395
Phone
(732) 923-6537
Fax
(732) 923-6536
NPI assigned
Jul 28, 2020
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101281326 VA Primary

Addresses

Primary practice location

300 2ND Ave
Long Branch, NJ 07740-6395

Mailing address

400 Sairs Ave Apt 3
Long Branch, NJ 07740-5629
Phone (917) 478-2546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240920001159 VA Practitioner - Internal Medicine 6002260320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians

Practice addresses (Care Compare)

7101 Jahnke Rd
Richmond, VA 23225-4017
Phone (804) 320-3911

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Aug 26, 2024 Accepting new patients

Locations

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

Organizations & group practices 1

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1417566134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SAIRS AVE APT 3",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077405629",
            "telephone_number": "917-478-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406395",
            "telephone_number": "732-923-6537",
            "fax_number": "732-923-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRPAL",
        "first_name": "VISHAKHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101281326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.