Vijay Pethkar, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

031687 Issued in TN

Practice address

780 North Mt Juliet Rd
Mt Juliet, TN 37122-0780

Phone

(615) 758-9273

Fax

(615) 758-4821

NPI assigned

Jul 13, 2005

Last updated

Feb 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Pulmonary Disease

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Skyline Medical Center Hospital, Nashville, TN, CCN 440006
• Tristar Stonecrest Medical Center Hospital, Smyrna, TN, CCN 440227
• Vanderbilt Wilson County Hospital Hospital, Lebanon, TN, CCN 440193

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vijay.pethkar@glacecentral.com
• Direct secure messaging: vpethk01@yourcarecommunity.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Vijay Pethkar MD PLLC

  • Pulmonary Disease Physician
  • Mount Juliet, TN
  • NPI 1356474415
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Health Services of Tennessee, Inc.

  dba TriStar StoneCrest Medical Center

  • General Acute Care Hospital
  • Smyrna, TN
  • NPI 1992776405
  Care Compare affiliation
• Hti Memorial Hospital Corporation

  dba Tristar Skyline Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1295780476
  Care Compare affiliation
• Vanderbilt University Medical Center

  dba Vanderbilt Wilson County Hospital

  • General Acute Care Hospital
  • Lebanon, TN
  • NPI 1306889597
  Care Compare affiliation

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1669470555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 NORTH MT JULIET RD",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371220780",
            "telephone_number": "615-727-1963",
            "fax_number": "615-758-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 NORTH MT JULIET RD",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371220780",
            "telephone_number": "615-758-9273",
            "fax_number": "615-758-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETHKAR",
        "first_name": "VIJAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD31687",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "031687",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TN",
            "license": "031687",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "4102896",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Perrotto, FNP-BC, PMHNP-BC
• Erin Danielle Perry, RDH
• Krista Perry
• Brian Peterson, APRN, FNP-BC
• Taryn Joy Peterson, LMFT
• Pharmacare Collaborative Partners
• Bayley McKenzie Pharr, MMFT
• Latoya Arlesia Phillips-Burkeen, LPC-MHSP
• Racheal Marie Phillips, LPC-MHSP
• Shannon Carnathan Phillips, PHARMD

• Pulmonary Disease Physician in Mount Juliet, TN
• Providers in Mount Juliet, TN by specialty
• Pulmonary Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; 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.
• 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.