Active NPI
Vijay Prasad, MD
- Pediatrics Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA11878500
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134300 | CA | MD | Clinical Social Worker |
| 25MA11878500 | NJ | MD | Pediatrics Physician |
| A134300 | CA | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group PC | Current | Accepting new patients | |
| Saint Peter'S Specialty Physicians, P.C. | Current | Accepting new patients | |
| Garden State Healthcare Associates, LLC | Current | Accepting new patients | |
| Barnabas Health Medical Group PC | Current | Accepting new patients | |
| New Jersey Medical and Health Associates,LLC | Current | 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
- 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.
-
- Specialist
- Elizabeth, NJ
- NPI 1841557246
-
- Emergency Medicine Physician
- Bayonne, NJ
- NPI 1700014545
-
- Internal Medicine Physician
- Hoboken, NJ
- NPI 1558673582
-
- Gastroenterology Physician
- Lakewood, NJ
- NPI 1861894982
-
- Durable Medical Equipment & Medical Supplies
- Hackensack, NJ
- NPI 1316772668
-
- General Acute Care Hospital
- Hoboken, NJ
- NPI 1043475668
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.