NPIMap

Individual provider Active NPI

Atchyuta Deepthi Vegulla, MBBS

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1821652421
Registry record updated Jun 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
U0869 Issued in TX
Practice address
585 Schenectady Ave
Brooklyn, NY 11203-1822
Phone
(718) 604-5401
NPI assigned
Apr 29, 2019
Last updated
Jun 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X NY
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X U0869 TX Primary

Addresses

Primary practice location

585 Schenectady Ave
Brooklyn, NY 11203-1822

Mailing address

87 Rector St
Millburn, NJ 07041-1102
Phone (309) 363-8704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230614000698 TX Practitioner - Internal Medicine 6901264522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Questcare Hospitalists PLLCGroup PAC ID 5799785119, 266 clinicians

Practice addresses (Care Compare)

900 8TH Ave
Ft Worth, TX 76104-3902
Phone (972) 562-8880

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Questcare Hospitalists PLLC Multi-Specialty CurrentSince Apr 11, 2023 Accepting new patients
Questcare Matrix, PLLC Multi-Specialty CurrentSince Mar 18, 2024 Accepting new patients
Questcare Matrix, PLLC Multi-Specialty CurrentSince Mar 18, 2024 Accepting new patients
Columbia Plaza Medical Center of Fort Worth Subsidiary LP Past Accepting new patients

Locations

2601 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 274-5571

550 E Ann Arbor Ave
Dallas, TX 75216
Phone (214) 376-1701

4201 Stonegate Blvd
Ft Worth, TX 76109
Phone (817) 924-5440

850 12th Ave
Ft Worth, TX 76104
Phone (817) 882-8289

900 8th Ave
Ft Worth, TX 76104
Phone (817) 336-2100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686355200000",
    "number": "1821652421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 RECTOR ST",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411102",
            "telephone_number": "309-363-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031822",
            "telephone_number": "718-604-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGULLA",
        "first_name": "ATCHYUTA",
        "middle_name": "DEEPTHI",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2023-06-10",
        "certification_date": "2023-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U0869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.