Vijayakumar Komareth, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

115491 Issued in NY

Practice address

1427 Genesee St
Utica, NY 13501-4343

Phone

(315) 738-1428

Fax

(315) 738-1461

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Psychiatry

Education

Other, 1968

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Neighborhood Center, IncGroup PAC ID 3678619897, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• The Neighborhood Center, Inc.

  • Mental Health Counselor
  • Utica, NY
  • NPI 1811088719
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1740348978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GALWAY RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132241",
            "fax_number": "315-733-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135014343",
            "telephone_number": "315-738-1428",
            "fax_number": "315-738-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMARETH",
        "first_name": "VIJAYAKUMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "115491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00474180",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abena N Koduah
• Michelle Koehler
• Becky Kogut
• Jordan Marie Kohn
• Marcus Kolber, MD
• Kond Medical LLC
• Margaret D Kordylewska
• Theresa L Korol, NP
• Ethan Michael Korotzer
• Elizabeth Grace Korrie, LMSW

• Psychiatry Physician in Utica, NY
• Providers in Utica, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.