Individual provider Active NPI

Vedam Gummadi, M.D.

  • Internal Medicine Physician
  • Camden, NJ
National Provider Identifier
1427253624
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06746600 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103
Phone
(856) 342-2000
NPI assigned
Jun 18, 2007
Last updated
Nov 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD068817L PA
Internal Medicine Physician 207R00000X 25MA06746600 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

501 Bath Rd
Bristol, PA 19007-3101
Phone (215) 248-8568

Other practice location 2

501 Bath Rd
Bristol, PA 19007-3101
Phone (215) 248-8568

Other identifiers 2

IdentifierTypeStateIssuer
1979746OtherPAHIGHMARK BLUE SHIELD
30060278OtherPAKEYSTONE MERCY-LOWER BUCKS GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20051004000795 NJ Practitioner - HospitalistPractitioner - Internal Medicine 0042245474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06746600NJMDInternal Medicine Physician
MD068817LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Physician Offices, PA Internal Medicine CurrentSince Dec 7, 2016 Accepting new patients
Virtua - Memorial Hospital Burlington County, Inc. Past Accepting new patients
Atlantic Professional Services of Rhode Island Incorporated Past Accepting new patients

Locations

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

2 Cooper Plz
Camden, NJ 08103
Phone (609) 342-7600

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

1210 Brace Rd
Cherry Hill, NJ 08034
Phone (609) 428-6616

90 Brick Rd
Marlton, NJ 08053
Phone (856) 355-6040

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

310 Salem Woodstown Rd
Salem, NJ 08079
Phone (856) 339-6054

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

Organizations & group practices 3

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1427253624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-342-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Bath Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "PA",
            "postal_code": "190073101",
            "country_code": "US",
            "telephone_number": "215-248-8568",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Bath Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "PA",
            "postal_code": "190073101",
            "country_code": "US",
            "telephone_number": "215-248-8568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUMMADI",
        "first_name": "VEDAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD068817L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06746600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1979746",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY-LOWER BUCKS GROUP",
            "identifier": "30060278",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.