Individual provider Active NPI

Vimratha Teepireddy

  • Physician Assistant
  • Marion, VA
National Provider Identifier
1851121933
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
565 Radio Hill Rd
Marion, VA 24354-6587
Phone
(276) 944-6342
NPI assigned
Aug 5, 2024
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

565 Radio Hill Rd
Marion, VA 24354-6587

Mailing address

597 Wingfoot Rd
Orange, CT 06477-2743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250403003607 CT Practitioner - Physician Assistant 8325562093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

1450 Chapel St
New Haven, CT 06511-4405
Phone (203) 789-3633

20 York St
New Haven, CT 06510-3220

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6962CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince May 5, 2025 Accepting new patients

Locations

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: vteepireddy493635@direct.ynhh.org

Organizations & group practices 1

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 2

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": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1851121933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 WINGFOOT RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064772743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 RADIO HILL RD",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243546587",
            "telephone_number": "276-944-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEPIREDDY",
        "first_name": "VIMRATHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, VA

Sources for this page

Verify at the official NPI Registry.