NPIMap

Organization Active NPI

Vesta, Inc.

  • Community/Behavioral Health Agency
  • Waldorf, MD
National Provider Identifier
1669656062
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VESTA, INC.
Practice address
22 Industrial Park Dr
Suite a
Waldorf, MD 20602-2791
Phone
(240) 296-6030
Fax
(301) 638-9992
NPI assigned
Dec 20, 2007
Last updated
May 9, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
VESTA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Authorized official

Name
Jignesh Dalal, CPA
Title
Ceo
Phone
(240) 296-6099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MD Primary

Addresses

Primary practice location

22 Industrial Park Dr
Suite a
Waldorf, MD 20602-2791

Mailing address

9301 Annapolis Rd
Suite 300
Lanham, MD 20706-3115
Phone (240) 296-5848

Other identifiers 2

IdentifierTypeStateIssuer
260991608MedicaidMD
949LOtherMDMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050411001119 MD Part B Supplier - Clinic/Group Practice 3678568375 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waldorf, MD; Lexington Park, MD; Odenton, MD

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Vesta Inc25 organizations share this tax ID, including this one
Part of
Vesta Inc

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1669656062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 ANNAPOLIS RD",
            "address_2": "SUITE 300",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063115",
            "telephone_number": "240-296-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 INDUSTRIAL PARK DR",
            "address_2": "SUITE A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022791",
            "telephone_number": "240-296-6030",
            "fax_number": "301-638-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VESTA, INC.",
        "enumeration_date": "2007-12-20",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "DALAL",
        "authorized_official_first_name": "JIGNESH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-296-6099",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260991608",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "949L",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.