Individual provider Active NPI

Vasundara Tummala, M.D.

  • Obstetrics & Gynecology Physician
  • Norwalk, CT
National Provider Identifier
1659604528
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
047836 Issued in CT
Practice address
120 Connecticut Ave
Norwalk, CT 06854-1525
Phone
(203) 899-1770
Fax
(203) 852-3982
NPI assigned
Sep 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 047836 CT Primary

Addresses

Primary practice location

120 Connecticut Ave
Norwalk, CT 06854-1525

Mailing address

16 Cranbury Rd
Westport, CT 06880-1814
Phone (678) 521-0478

Other identifiers 1

IdentifierTypeStateIssuer
0035774OtherCTCT SUBSTANCE REGISTRATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090928000484 CT Practitioner - Obstetrics/Gynecology 5698821908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Georgia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norwalk Community Health Center IncGroup PAC ID 6305988510, 29 clinicians

Practice addresses (Care Compare)

120 Connecticut Ave
Norwalk, CT 06854-1525
Phone 20389917708005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047836CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Community Health Center Inc CurrentSince Apr 5, 2016 Accepting new patients
Optimus Health Care CurrentSince Aug 16, 2021 Accepting new patients
Optimus Health Care Inc CurrentSince Aug 16, 2021 Accepting new patients

Locations

64 Black Rock Ave
Bridgeport, CT 06605
Phone (203) 579-5000

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

57 Fillow St
Norwalk, CT 06850

120 Connecticut Ave
Norwalk, CT 06854
Phone (203) 851-1000

1 Park St
Norwalk, CT 06851
Phone (203) 212-6533

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCDGCD
  • Direct secure messaging: vasundara.tummala.1@10170.direct.athenahealth.com
  • Direct secure messaging: vasundara.tummala@nchc1.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1659604528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CRANBURY RD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068801814",
            "telephone_number": "678-521-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CONNECTICUT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541525",
            "telephone_number": "203-899-1770",
            "fax_number": "203-852-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMMALA",
        "first_name": "VASUNDARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "047836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT SUBSTANCE REGISTRATION",
            "identifier": "0035774",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.