NPIMap

Individual provider Active NPI

Vijaya Nimma, M.D.

  • Pediatrics Physician
  • Edison, NJ
National Provider Identifier
1669573648
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA07473400 Issued in NJ
Practice address
6 Nicholas CT
Edison, NJ 08820-2244
Phone
(732) 902-6395
NPI assigned
Sep 25, 2006
Last updated
Jun 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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 25MA07473400 NJ Primary

Addresses

Primary practice location

6 Nicholas CT
Edison, NJ 08820-2244

Mailing address

906 Oak Tree Ave Ste a
South Plainfield, NJ 07080-5127
Phone (732) 902-6395

Other identifiers 1

IdentifierTypeStateIssuer
0003603MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060119000232 NJ Practitioner - Pediatric Medicine 9830113687 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07473400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Health Initiatives Inc Pediatrics Current Accepting new patients
Ocean Health Initiatives,Inc CurrentSince Jun 14, 2014 Accepting new patients
Newark Community Health Centers, Inc CurrentSince May 28, 2010 Accepting new patients
Ocean Health Initiatives, Inc CurrentSince Jun 14, 2014 Accepting new patients
Neighborhood Health Services Corporation Pediatrics CurrentSince Oct 1, 2017 Accepting new patients
Newark Community Health Centers, Inc. CurrentSince May 28, 2010 Accepting new patients
Colonia Pediatrics, LLC Pediatrics PastSince Sep 15, 2024 Accepting new patients
Emergency Medical Associates of New Jersey PA PastSince May 10, 2020 Accepting new patients
Clara Maass Medical Center House Physicians Pediatrics Past Accepting new patients
Gaurang Patel MD LLC Pediatrics PastSince Jun 30, 2024 Accepting new patients

Locations

184 1st St
Elizabeth, NJ 07206
Phone (908) 355-4459

101 2nd St
Lakewood, NJ 08701
Phone (732) 886-4809

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

1700 Myrtle Ave
#58
Plainfield, NJ 07063
Phone (908) 753-6401

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA
  • Direct secure messaging: vijaya.nimma.p1@direct.nhscnj.nextgenshare.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1669573648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 OAK TREE AVE STE A",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805127",
            "telephone_number": "732-902-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 NICHOLAS CT",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202244",
            "telephone_number": "732-902-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMMA",
        "first_name": "VIJAYA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07473400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.