Active NPI
Vijendra Kotturi, M.D.
- Internal Medicine Physician
- Renton, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 25MA09045100
- Practice address
- 400 S 43Rd St
Renton, WA 98055-5714 - Phone
- (425) 228-3220
- Fax
- (253) 395-1954
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD60051023 | WA | |
| Hospitalist Physician | 208M00000X | MD60051023 | WA | |
| Hospitalist Physician | 208M00000X | 25MA09045100 | NJ | |
| Internal Medicine Physician | 207R00000X | 25MA09045100 | NJ | Primary |
Addresses
Primary practice location
400 S 43Rd St
Renton, WA 98055-5714
Mailing address
PO Box 59028
Renton, WA 98058-2028
Phone (425) 251-5110
Other practice location 1
175 Madison Ave Fl 1
Mount Holly, NJ 08060-2038
Phone (609) 914-6000
Other practice location 2
90 Brick Rd Fl 3
Marlton, NJ 08053-2177
Phone (856) 355-6000
Other practice location 3
1600 Haddon Ave Fl 6
Camden, NJ 08103-3101
Phone (856) 757-3500
Other practice location 4
100 Bowman Dr Lowr Level1
Voorhees, NJ 08043-9612
Phone (856) 247-3000
Other practice location 5
218 Sunset Rd Fl 5
Willingboro, NJ 08046-1110
Phone (609) 444-0599
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00927875 | Other | WA | MEDICARE RAILROAD |
| 0272031 | Other | WA | L&I |
| 2002120 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | vkotturi18468@directvirtua.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260
175 Madison Ave
Mount Holly, NJ 08060-2038
3242 Route 206
Bordentown, NJ 08505-4517
90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260
Hospital & facility affiliations
- Virtua Mount Holly Hospital
- West Jersey Hospital
- Virtua Our Lady of Lourdes Hospital
- Virtua Willingboro Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.15 of 100
- Quality
- 62.28
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.89
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60051023 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Virtua Medical Group, PA | Internal Medicine | Current | Accepting new patients |
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Virtua - Memorial Hospital Burlington County, Inc. | Past | Accepting new patients |
Locations
3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340
1600 Haddon Ave
Fl 6
Camden, NJ 08103
Phone (856) 247-2160
301 Lippincott Dr
Ste 120
Marlton, NJ 08053
Phone (856) 355-0333
90 Brick Rd
Fl 3
Marlton, NJ 08053
Phone (856) 247-2160
175 Madison Ave
Fl 1
Mount Holly, NJ 08060
Phone (609) 914-6000
175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660
100 Bowman Dr
Lowr
Voorhees, NJ 08043
Phone (856) 247-3000
218 Sunset Rd
Fl 5
Willingboro, NJ 08046
Phone (609) 444-0359
Interoperability endpoints
- vkotturi18468@directvirtua.org
Organizations & group practices 4
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.
-
- Orthopaedic Surgery Physician
- Delran, NJ
- NPI 1841087988
-
- Urgent Care Clinic/Center
- Voorhees, NJ
- NPI 1912457755
-
- General Acute Care Hospital
- Mount Holly, NJ
- NPI 1134125016
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mount Holly, NJ
- NPI 1134125016
-
- General Acute Care Hospital
- Voorhees, NJ
- NPI 1528064409
-
- General Acute Care Hospital
- Camden, NJ
- NPI 1235134024
-
- General Acute Care Hospital
- Willingboro, NJ
- NPI 1053316844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703721600000",
"number": "1669679700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 59028",
"city": "RENTON",
"state": "WA",
"postal_code": "980582028",
"telephone_number": "425-251-5110",
"fax_number": "425-793-7458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S 43RD ST",
"city": "RENTON",
"state": "WA",
"postal_code": "980555714",
"telephone_number": "425-228-3220",
"fax_number": "253-395-1954"
}
],
"practiceLocations": [
{
"address_1": "175 Madison Ave Fl 1",
"address_purpose": "LOCATION",
"city": "Mount Holly",
"state": "NJ",
"postal_code": "080602038",
"country_code": "US",
"telephone_number": "609-914-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "90 Brick Rd Fl 3",
"address_purpose": "LOCATION",
"city": "Marlton",
"state": "NJ",
"postal_code": "080532177",
"country_code": "US",
"telephone_number": "856-355-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1600 Haddon Ave Fl 6",
"address_purpose": "LOCATION",
"city": "Camden",
"state": "NJ",
"postal_code": "081033101",
"country_code": "US",
"telephone_number": "856-757-3500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Bowman Dr Lowr Level1",
"address_purpose": "LOCATION",
"city": "Voorhees",
"state": "NJ",
"postal_code": "080439612",
"country_code": "US",
"telephone_number": "856-247-3000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "218 Sunset Rd Fl 5",
"address_purpose": "LOCATION",
"city": "Willingboro",
"state": "NJ",
"postal_code": "080461110",
"country_code": "US",
"telephone_number": "609-444-0599",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOTTURI",
"first_name": "VIJENDRA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2023-12-28",
"certification_date": "2023-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD60051023",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WA",
"license": "MD60051023",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NJ",
"license": "25MA09045100",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA09045100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00927875",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0272031",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2002120",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "vkotturi18468@directvirtua.org",
"affiliation": "N",
"address_1": "175 Madison Ave Fl 1",
"city": "Mount Holly",
"state": "NJ",
"country_code": "US",
"postal_code": "080602038",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.