Individual provider Active NPI

Sagar Raju Vegesna, PHARMD

  • Pharmacist
  • Roxbury, MA
National Provider Identifier
1912349259
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH234740 Issued in MA
Practice address
416 Warren St
Roxbury, MA 02119-1831
Phone
(617) 541-0310
NPI assigned
Jul 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH234740 MA Primary

Addresses

Primary practice location

416 Warren St
Roxbury, MA 02119-1831

Mailing address

416 Warren St
Roxbury, MA 02119-1831
Phone (617) 541-0310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH234740MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1912349259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 WARREN ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191831",
            "telephone_number": "617-541-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 WARREN ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191831",
            "telephone_number": "617-541-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGESNA",
        "first_name": "SAGAR",
        "middle_name": "RAJU",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH234740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.