Individual provider Active NPI

Vijaya K Vudathaneni, MD

  • Hospitalist Physician
  • Columbus, IN
National Provider Identifier
1457623548
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01091653A Issued in IN
Practice address
2400 17TH St
Columbus, IN 47201-5351
Phone
(812) 375-5974
NPI assigned
Feb 3, 2012
Last updated
Sep 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 258418 MA
Hospitalist Physician 208M00000X 258418 MA
Hospitalist Physician 208M00000X 01091653A IN Primary

Addresses

Primary practice location

2400 17TH St
Columbus, IN 47201-5351

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Other practice location 1

759 Chestnut Street
Springfield, MA 01199-1619
Phone (413) 794-4320

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vvudathaneni50776@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231204002103 IN Practitioner - HospitalistPractitioner - Internal Medicine 2365669082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 17TH St
Columbus, IN 47201-5351
Phone (812) 376-5974

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Physicians, LLC Internal Medicine CurrentSince Jan 15, 2024 Accepting new patients
Columbus Regional Health Physicians, LLC CurrentSince Jan 15, 2024 Accepting new patients

Locations

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: vvudathaneni50776@edirect.crh.org
  • Direct secure messaging: vvudthaneni842393@nychhc.direct-ci.com

Organizations & group practices 2

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 3

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": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1457623548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 17TH ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015351",
            "telephone_number": "812-375-5974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Chestnut Street",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011991619",
            "country_code": "US",
            "telephone_number": "413-794-4320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VUDATHANENI",
        "first_name": "VIJAYA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-03",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "258418",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "258418",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01091653A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vvudathaneni50776@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct address",
            "address_1": "2400 17th St",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.