Individual provider Active NPI

Vijay Prasad, MD

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1710370440
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA11878500 Issued in NJ
Practice address
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone
(323) 361-4100
Fax
(323) 361-3642
NPI assigned
Mar 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 134300 CA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X A134300 CA
Pediatrics Physician 208000000X 25MA11878500 NJ Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Los Angeles, CA 90027-6062

Mailing address

3701 Wilshire Boulevard
Suite #600
Los Angeles, CA 90010-2814
Phone (323) 361-3550

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719002187 NJ Practitioner - Pediatric Medicine 0446546766 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
134300CAMDClinical Social Worker
25MA11878500NJMDPediatrics Physician
A134300CAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Oct 12, 2025 Accepting new patients
Saint Peter'S Specialty Physicians, P.C. CurrentSince Sep 1, 2025 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Apr 2, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 12, 2025 Accepting new patients
New Jersey Medical and Health Associates,LLC CurrentSince Jun 15, 2023 Accepting new patients
Humc Opco LLC Past Accepting new patients

Locations

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

122 Clinton St
Hoboken, NJ 07030
Phone (201) 418-1415

122 Clinton St
Fl 2
Hoboken, NJ 07030
Phone (201) 479-5206

150 Warren St
Jersey City, NJ 07302
Phone (201) 309-3000

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

500 River Ave
Ste 110
Lakewood, NJ 08701
Phone (732) 339-7360

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

Interoperability endpoints

  • Direct secure messaging: vijay.prasad.1@8568.direct.athenahealth.com

Organizations & group practices 6

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": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1710370440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 WILSHIRE BOULEVARD",
            "address_2": "SUITE #600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102814",
            "telephone_number": "323-361-3550",
            "fax_number": "323-361-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-4100",
            "fax_number": "323-361-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "VIJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-04",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "134300",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "A134300",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA11878500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.