NPIMap

Individual provider Active NPI

Vivekkumar V Dasondi, MD

  • Internal Medicine Physician
  • Galloway, NJ
National Provider Identifier
1528129509
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08110600 Issued in NJ
Practice address
72 W Jimmie Leeds Rd
#2100
Galloway, NJ 08205-9406
Phone
(609) 652-1115
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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 25MA08110600 NJ Primary
Hospitalist Physician 208M00000X 25MA08110600 NJ

Addresses

Primary practice location

72 W Jimmie Leeds Rd
#2100
Galloway, NJ 08205-9406

Mailing address

72 W Jimmie Leeds Rd
#2100
Galloway, NJ 08205-9406
Phone (609) 652-1115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070808000797 NJ Practitioner - Internal Medicine 9032200852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

310 Chris Gaupp Dr
Suite 100a
Galloway, NJ 08205-4461
Phone (609) 652-1115

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08110600NJMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Primary Care PC Internal Medicine CurrentSince Jul 1, 2008 Accepting new patients
Atlanticare Physician Group CurrentSince May 4, 2014 Accepting new patients
Galloway Nursing & Rehab LLC PastSince Oct 3, 2019 Accepting new patients

Locations

1102 Atlantic Ave
Atlantic City, NJ 08401
Phone (609) 345-8409

2500 English Creek Ave
Ste 800
Egg Hbr Twp, NJ 08234
Phone (609) 407-2277

72 W Jimmie Leeds Rd
Ste 2100
Galloway, NJ 08205
Phone (609) 652-1115

76 W Jimmie Leeds Rd
Ste 301
Galloway, NJ 08205
Phone (609) 404-1200

310 Chris Gaupp Dr
Ste 100A
Galloway, NJ 08205
Phone (609) 652-1115

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDEGAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/GDEGAA/Endpoint/GDEGAA

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Health Center at GallowayGalloway Township, NJ, CCN 315210 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 3, 2019
Oct 3, 2019
Mystic Meadows Rehabilitation and Nursing CenterLittle Egg Harbor TWP, NJ, CCN 315456 Skilled nursing facility Corporate Director Nov 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1528129509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 W JIMMIE LEEDS RD",
            "address_2": "#2100",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059406",
            "telephone_number": "609-652-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 W JIMMIE LEEDS RD",
            "address_2": "#2100",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059406",
            "telephone_number": "609-652-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASONDI",
        "first_name": "VIVEKKUMAR",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08110600",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA08110600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.