Active NPI
Radhika Vemuri
- Internal Medicine Physician
- Broomfield, CO
National Provider Identifier
1649530551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DR.0061658
- Practice address
- 5023 W 120TH Ave Ste 312
Broomfield, CO 80020-5606 - Phone
- (720) 644-9355
- NPI assigned
- May 24, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | DR.0061658 | CO | Primary |
Addresses
Primary practice location
5023 W 120TH Ave Ste 312
Broomfield, CO 80020-5606
Mailing address
5023 W 120TH Ave Ste 312
Broomfield, CO 80020-5606
Phone (720) 644-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250102001041 | CO | Order and Referring Only - Nephrology | 2668600875 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0061658 | CO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575590400000",
"number": "1649530551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5023 W 120TH AVE STE 312",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800205606",
"telephone_number": "720-644-9355",
"fax_number": "720-523-1654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5023 W 120TH AVE STE 312",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800205606",
"telephone_number": "720-644-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEMURI",
"first_name": "RADHIKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-24",
"last_updated": "2019-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "DR.0061658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.