Individual provider Active NPI

Vimala Devi Nuthakki, M.D.

  • Obstetrics & Gynecology Physician
  • North Brunswick, NJ
National Provider Identifier
1861741019
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA09072900 Issued in NJ
Practice address
1555 Ruth Rd Ste 5
North Brunswick, NJ 08902-4074
Phone
(732) 398-3939
Fax
(732) 398-0909
NPI assigned
Sep 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA09072900 NJ Primary

Addresses

Primary practice location

1555 Ruth Rd Ste 5
North Brunswick, NJ 08902-4074

Mailing address

PO Box 22581
New York, NY 10087-2581
Phone (856) 669-6050

Other practice location 1

666 Plainsboro Rd Ste 316
Plainsboro, NJ 08536-3074
Phone (609) 716-6161

Other practice location 2

1 Ethel Rd Ste 108
Edison, NJ 08817-2838
Phone (732) 662-4300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vimala.nuthakki@axia.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20201208001466 NJ Practitioner - Obstetrics/Gynecology 6507278082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Womens Health Group LLCGroup PAC ID 2961316328, 352 clinicians

Practice addresses (Care Compare)

1 Ethel Rd
Suite 108 Haven Women'S Health
Edison, NJ 08817-2838
Phone (732) 398-3939

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09072900NJMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: vimala.nuthakki@axia.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1861741019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22581",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100872581",
            "telephone_number": "856-669-6050",
            "fax_number": "856-528-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 RUTH RD STE 5",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089024074",
            "telephone_number": "732-398-3939",
            "fax_number": "732-398-0909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "666 Plainsboro Rd Ste 316",
            "address_purpose": "LOCATION",
            "city": "Plainsboro",
            "state": "NJ",
            "postal_code": "085363074",
            "country_code": "US",
            "telephone_number": "609-716-6161",
            "fax_number": "732-398-0909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Ethel Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088172838",
            "country_code": "US",
            "telephone_number": "732-662-4300",
            "fax_number": "732-398-0909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUTHAKKI",
        "first_name": "VIMALA",
        "middle_name": "DEVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA09072900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vimala.nuthakki@axia.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1555 Ruth Rd Ste 5",
            "city": "North Brunswick",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "089024074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.