Organization Active NPI

Vijay Kumar M D a Medical Corporation

  • Pulmonary Disease Physician
  • Simi Valley, CA
National Provider Identifier
1811024805
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A46673 Issued in CA
Legal business name
VIJAY KUMAR M D A MEDICAL CORPORATION
Doing business as
Vijay Kumar M D A Medical Corporation
Practice address
1174 Amazon Way
Simi Valley, CA 93065-3156
Phone
(805) 527-5878
Fax
(805) 527-0114
NPI assigned
Feb 27, 2007
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Vijay KumarNPI 1689638587
Title
Owner
Phone
(805) 527-5878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A46673 CA Primary

Addresses

Primary practice location

1174 Amazon Way
Simi Valley, CA 93065-3156

Mailing address

1174 Amazon Way
Simi Valley, CA 93065-3156
Phone (805) 527-5878

Other identifiers 11

IdentifierTypeStateIssuer
00A466730OtherCABLUE SHIELD
GF413ZOtherCAMEDICARE TYPE 1 PTAN EFFECT 6/27/2012
00A466730MedicaidCA
A46673OtherCALICENSE
1811024805OtherCANPI - CORPORATION TYPE 2
1689638587OtherCANPI - INDIVIDUAL PROFESSIONAL TYPE 1
1689638587OtherCANPI INDIVIDUAL NUMBER
GE519AOtherCAMEDICARE TYPE 2 PTAN EFFECT 6/27/2012
W15531OtherCAMEDICARE PTAN DEACTIVATED 6/26/2012
CMCSUBK0SOtherCAMEDICAID SUBMITTER NUMBER
W15531OtherCAMEDICARE (PTAN) PROVIDER NUMBER

Other names 2

  • Vijay Kumar M D A Medical Corporation Doing business as
  • Vijay Kumar Kundal Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120705000536 CA Part B Supplier - Clinic/Group Practice 0648435255 Receives reassigned benefits from 2 practitioners
Practice locations: Simi Valley, CA

National Provider Directory

National Provider Directory

Locations

1174 Amazon Way
Simi Valley, CA 93065
Phone (805) 527-5878

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1811024805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 AMAZON WAY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653156",
            "telephone_number": "805-527-5878",
            "fax_number": "805-527-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 AMAZON WAY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653156",
            "telephone_number": "805-527-5878",
            "fax_number": "805-527-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIJAY KUMAR M D A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "VIJAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-527-5878"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A46673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A466730",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TYPE 1 PTAN EFFECT 6/27/2012",
            "identifier": "GF413Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A466730",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A46673",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - CORPORATION TYPE 2",
            "identifier": "1811024805",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - INDIVIDUAL PROFESSIONAL TYPE 1",
            "identifier": "1689638587",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1689638587",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TYPE 2 PTAN EFFECT 6/27/2012",
            "identifier": "GE519A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN DEACTIVATED 6/26/2012",
            "identifier": "W15531",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID SUBMITTER NUMBER",
            "identifier": "CMCSUBK0S",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (PTAN) PROVIDER NUMBER",
            "identifier": "W15531",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vijay Kumar M D A Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vijay Kumar Kundal",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.