Individual provider Active NPI

Rama Vaidyanathan, MD

  • Internal Medicine Physician
  • West Allis, WI
National Provider Identifier
1447226212
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T9267 Issued in TX
Practice address
2514 S 102ND St
Ste. 160
West Allis, WI 53227-2142
Phone
(414) 255-0300
Fax
(414) 543-9601
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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 47214 WI
Internal Medicine Physician 207R00000X T9267 TX Primary

Addresses

Primary practice location

2514 S 102ND St
Ste. 160
West Allis, WI 53227-2142

Mailing address

PO Box 639295 Dept 93394
Cincinnati, OH 45263-9295
Phone (248) 842-6600

Other practice location 1

7800 Shoal Creek Blvd Ste 130W
Austin, TX 78757-1040
Phone (512) 407-8880

Other practice location 2

7800 Shoal Creek Blvd Ste 130W
Austin, TX 78757-1040
Phone (512) 407-8880

Other practice location 3

5414 Fredericksburg Rd Ste 100A
San Antonio, TX 78229-3641
Phone (210) 468-0800

Other practice location 4

606 Oakesdale Ave SW Ste C200
Renton, WA 98057-5227
Phone (866) 259-1629

Other identifiers 1

IdentifierTypeStateIssuer
34566100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230320000910 TX Practitioner - Internal Medicine 1052205580 Reassigns benefits to 1 organization
I20240903000816 WA Practitioner - Internal Medicine 1052205580 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47214WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Feb 1, 2023 Accepting new patients
Iah of Wisconsin, PLLC CurrentSince Jan 1, 2015 Accepting new patients
Vpa PC Internal Medicine CurrentSince Aug 2, 2004 Accepting new patients
Vpa PC Internal Medicine Current Accepting new patients
Vpa PC CurrentSince Aug 2, 2004 Accepting new patients
Vpa PC Internal Medicine CurrentSince Aug 19, 2024 Accepting new patients
Vpa of Texas PLLC Internal Medicine Current Accepting new patients
Vpa of Texas PLLC CurrentSince Feb 1, 2023 Accepting new patients
Vpa PC Current Accepting new patients

Locations

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

7800 Shoal Creek Blvd
Ste 130W
Austin, TX 78757
Phone (713) 874-0012

7800 Shoal Creek Blvd
Ste 118W
Austin, TX 78757
Phone (512) 374-0700

5414 Fredericksburg Rd
Ste 100A
San Antonio, TX 78229
Phone (210) 468-0800

606 Oakesdale Ave SW
Ste C200
Renton, WA 98057
Phone (866) 259-1629

13555 Bishops Ct
Ste 315
Brookfield, WI 53005
Phone (414) 255-0300

2514 S 102nd St
Ste 160
West Allis, WI 53227
Phone (414) 255-0300

Organizations & group practices 9

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1447226212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639295 DEPT 93394",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639295",
            "telephone_number": "248-842-6600",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 S 102ND ST",
            "address_2": "STE. 160",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272142",
            "telephone_number": "414-255-0300",
            "fax_number": "414-543-9601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7800 Shoal Creek Blvd Ste 130W",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787571040",
            "country_code": "US",
            "telephone_number": "512-407-8880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7800 Shoal Creek Blvd Ste 130W",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787571040",
            "country_code": "US",
            "telephone_number": "512-407-8880",
            "fax_number": "512-407-8681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5414 Fredericksburg Rd Ste 100A",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293641",
            "country_code": "US",
            "telephone_number": "210-468-0800",
            "fax_number": "210-733-8649",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "606 Oakesdale Ave SW Ste C200",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980575227",
            "country_code": "US",
            "telephone_number": "866-259-1629",
            "fax_number": "855-666-8541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAIDYANATHAN",
        "first_name": "RAMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "47214",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T9267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34566100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.