Organization Active NPI

Vital Medical Care, LLC

  • Internal Medicine Physician
  • Moorestown, NJ
National Provider Identifier
1598995441
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06796000 Issued in NJ
Legal business name
VITAL MEDICAL CARE, LLC
Practice address
212 W Route 38 Ste 540
Moorestown, NJ 08057-3246
Phone
(856) 787-0260
Fax
(856) 787-0262
NPI assigned
Jul 24, 2009
Last updated
Jul 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Authorized official

Name
Nishith M GamiNPI 1295786440
Title
Physician
Phone
(856) 787-0260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA06796000 NJ Primary

Addresses

Primary practice location

212 W Route 38 Ste 540
Moorestown, NJ 08057-3246

Mailing address

203 Eclipse Dr
Bordentown, NJ 08505-2255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180627000357 NJ Part B Supplier - Clinic/Group Practice 4789930173 Receives reassigned benefits from 1 practitioner
Practice locations: Burlington, NJ; Marlton, NJ; Moorestown, NJ; Westhampton, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2009466Vital Medical Care, LLC212 W Route 38 Suite 540, Moorestown, NJ 08057Certificate of waiverJul 5, 2028

National Provider Directory

National Provider Directory

Locations

55 Route 70 E
Ste 2
Marlton, NJ 08053
Phone (856) 396-0260

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1598995441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 ECLIPSE DR",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085052255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W ROUTE 38 STE 540",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573246",
            "telephone_number": "856-787-0260",
            "fax_number": "856-787-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL MEDICAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-24",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "GAMI",
        "authorized_official_first_name": "NISHITH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "856-787-0260"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06796000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.