Individual provider Active NPI

Radha D Vijayakumar, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Lexington, MA
National Provider Identifier
1427020692
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
208879 Issued in MA
Practice address
5 Ballard Ter
Lexington, MA 02420-3201
Phone
(781) 862-1607
Fax
(781) 862-1607
NPI assigned
Feb 2, 2006
Last updated
Nov 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 208879 MA Primary

Addresses

Primary practice location

5 Ballard Ter
Lexington, MA 02420-3201

Mailing address

736 Cambridge Street
Boston, MA 02135-2997
Phone (617) 789-3023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040921000660 MA Practitioner - Physical Medicine and Rehabilitation 2466420195 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation Care, LLC Physical Medicine & Rehabilitation CurrentSince Mar 1, 2015 Accepting new patients
Neighborhealth Corporation Past Accepting new patients
Cap Anesthesia, PC Past Accepting new patients
Boston Rehabilitation Medicine Associates, Inc. Physical Medicine & Rehabilitation PastSince Sep 5, 2007 Accepting new patients

Locations

9700 Gross Point Rd
Skokie, IL 60076
Phone (847) 674-7210

150 Lincoln St
Needham, MA 02492
Phone (781) 449-4040

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1427020692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352997",
            "telephone_number": "617-789-3023",
            "fax_number": "617-789-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BALLARD TER",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024203201",
            "telephone_number": "781-862-1607",
            "fax_number": "781-862-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYAKUMAR",
        "first_name": "RADHA",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "208879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.