Individual provider Active NPI

Visala V Nanduri, M.D.

  • Internal Medicine Physician
  • Livingston, NJ
National Provider Identifier
1659398386
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07707100 Issued in NJ
Practice address
315 E Northfield Rd
Suite # 1D
Livingston, NJ 07039-4896
Phone
(973) 992-0658
Fax
(973) 992-6655
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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 25MA07707100 NJ Primary

Addresses

Primary practice location

315 E Northfield Rd
Suite # 1D
Livingston, NJ 07039-4896

Mailing address

13 Blue Bird CT
Randolph, NJ 07869-2127
Phone (973) 992-0658

Other identifiers 1

IdentifierTypeStateIssuer
0110515MedicaidNJ

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272931200000",
    "number": "1659398386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 BLUE BIRD CT",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692127",
            "telephone_number": "973-992-0658",
            "fax_number": "973-992-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E NORTHFIELD RD",
            "address_2": "SUITE # 1D",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394896",
            "telephone_number": "973-992-0658",
            "fax_number": "973-992-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDURI",
        "first_name": "VISALA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07707100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110515",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; 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.