Individual provider Active NPI

Vinson T Varughese, PA-C

  • Physician Assistant
  • Plainfield, NJ
National Provider Identifier
1922383231
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
117-119 Roosevelt Avenue
Plainfield, NJ 07060
Phone
(908) 756-6870
NPI assigned
Oct 18, 2011
Last updated
Jul 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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 NU Primary

Addresses

Primary practice location

117-119 Roosevelt Avenue
Plainfield, NJ 07060

Mailing address

117-119 Roosevelt Avenue
Plainfield, NJ 07060-2805
Phone (908) 756-6870

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161006000089 NJ Practitioner - Physician Assistant 4385818269 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Jersey Health and Wellness LLCGroup PAC ID 3375846637, 16 clinicians

Practice addresses (Care Compare)

35 S Spruce St
Ramsey, NJ 07446-2549
Phone (201) 819-8545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2677CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 3, 2016 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 3, 2016 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Feb 15, 2018 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Feb 15, 2018 Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1922383231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117-119 ROOSEVELT AVENUE",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070602805",
            "telephone_number": "908-756-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117-119 ROOSEVELT AVENUE",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "07060",
            "telephone_number": "908-756-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARUGHESE",
        "first_name": "VINSON",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-18",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, NJ

Sources for this page

Verify at the official NPI Registry.