Individual provider Active NPI

Vamsi Krishna Mootha, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1528040615
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
210078 Issued in MA
Practice address
185 Cambridge St
CPZN-5806
Boston, MA 02114-2790
Phone
(617) 643-3096
Fax
(617) 726-5735
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 210078 MA Primary

Addresses

Primary practice location

185 Cambridge St
CPZN-5806
Boston, MA 02114-2790

Mailing address

15 Valentine St
Unit #15
Cambridge, MA 02139-4032
Phone (617) 945-9445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
210078MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528040615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 VALENTINE ST",
            "address_2": "UNIT #15",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394032",
            "telephone_number": "617-945-9445",
            "fax_number": "617-726-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 CAMBRIDGE ST",
            "address_2": "CPZN-5806",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142790",
            "telephone_number": "617-643-3096",
            "fax_number": "617-726-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOTHA",
        "first_name": "VAMSI",
        "middle_name": "KRISHNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "210078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.