Individual provider Active NPI

Vani Venkatachalam, MD, FAAP

  • Pediatrics Physician
  • Irving, TX
National Provider Identifier
1659685709
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q5116 Issued in TX
Practice address
2651 Texas Dr Ste a
Irving, TX 75062-7016
Phone
(972) 893-1192
NPI assigned
Jul 31, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q5116 TX Primary

Addresses

Primary practice location

2651 Texas Dr Ste a
Irving, TX 75062-7016

Mailing address

111 Tennyson PL
Coppell, TX 75019-5358
Phone (434) 228-0388

Other identifiers 3

IdentifierTypeStateIssuer
0101254197OtherVALICENSE
Q5116OtherTXLICENSE
1518550474MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drvani@cacpeds.opdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20130617000243 VA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1254570690

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q5116TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VV Pedi Consults PLLC Pediatrics CurrentSince Feb 14, 2021 Accepting new patients
MD Pediatric Associates, P.a. Pediatrics PastSince Aug 1, 2020 Accepting new patients

Locations

2651 Texas Dr
Ste A
Irving, TX 75062
Phone (972) 893-1192

2651 Texas Dr
Irving, TX 75062
Phone (972) 252-7521

1121 Kinwest Pkwy
Ste 150
Irving, TX 75063

Interoperability endpoints

  • Direct secure messaging: drvani@cacpeds.opdirect.net

Organizations & group practices 2

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": "1280534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1659685709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TENNYSON PL",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750195358",
            "telephone_number": "434-228-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 TEXAS DR STE A",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750627016",
            "telephone_number": "972-893-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATACHALAM",
        "first_name": "VANI",
        "name_prefix": "Dr.",
        "credential": "MD, FAAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-31",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q5116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0101254197",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "Q5116",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518550474",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drvani@cacpeds.opdirect.net",
            "affiliation": "N",
            "address_1": "2651 Texas Dr Ste A",
            "city": "Irving",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750627016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.