Individual provider Active NPI

Vrinda Mahajan, M.D.

  • Internal Medicine Physician
  • St Louis, MO
National Provider Identifier
1790997724
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2006013738 Issued in MO
Practice address
6420 Clayton Rd
St Louis, MO 63117
Phone
(314) 768-8000
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2006013738 MO Primary

Addresses

Primary practice location

6420 Clayton Rd
St Louis, MO 63117

Mailing address

7090 Oakland Ave
1- E
St Louis, MO 63117
Phone (314) 255-7041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20160819001836 DC Practitioner - NephrologyPractitioner - Internal Medicine 6608902143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montgomery Renal Associates P.a.Group PAC ID 0042345464, 5 clinicians

Practice addresses (Care Compare)

3941 Ferrara Dr
Silver Spring, MD 20906-4709
Phone (301) 942-5355

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006013738MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2016 Accepting new patients
MGMC, LLC CurrentSince Jul 1, 2016 Accepting new patients
Montgomery Renal Associates P.a. CurrentSince Aug 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

15225 Shady Grove Rd
Ste 104
Rockville, MD 20850
Phone (301) 330-0550

3941 Ferrara Dr
Silver Spring, MD 20906
Phone (301) 340-1510

Interoperability endpoints

  • Direct secure messaging: vmahajan42105@direct.davitaphysiciansolutions.com

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790997724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7090 OAKLAND AVE",
            "address_2": "1- E",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63117",
            "telephone_number": "314-255-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63117",
            "telephone_number": "314-768-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "VRINDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2006013738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis, MO

Sources for this page

Verify at the official NPI Registry.