Shiva Gopal Vasishta, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

25MA55133 Issued in NJ

Practice address

2301 Evesham Road
Pavilion 800 Suite 209
Voorhees, NJ 08043

Phone

(856) 651-0060

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shiva.vasishta.1@11679.direct.athenahealth.com

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.

• Advanced Spine and Pain LLC

  • Interventional Pain Medicine Physician
  • Hammonton, NJ
  • NPI 1730359084

  Neurology

  Medicare reassignment NPD
• Eastern Neurodiagnostic Assoc PC

  • Neurology Physician
  • Voorhees, NJ
  • NPI 1023177102
  NPD Authorized official
• Advanced Spine and Pain, LLC

  • Pain Medicine Physician
  • Phoenixville, PA
  • NPI 1740996586

  Neurology

  NPD
• Advanced Spine and Pain, LLC

  • Pain Medicine Physician
  • Egg Harbor Township, NJ
  • NPI 1447885116
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1932269982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 EVESHAM ROAD",
            "address_2": "PAVILION 800 SUITE 209",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "08043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 EVESHAM ROAD",
            "address_2": "PAVILION 800 SUITE 209",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-651-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASISHTA",
        "first_name": "SHIVA",
        "middle_name": "GOPAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA55133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Varlotta, M.D.
• Vascular Care Centers LLC
• Namrata Vashishta, MD
• Vasisht Plastic and Reconstructive Surgery, PC
• Bhupesh Vasisht, M.D.
• Regina Vassallo, PHARMD
• Kelly Vazquez, APN
• Veena S Gandhi M.D. P.a.
• Chandani Vekaria, MD
• Vekkos Medical Associates, Inc

• Neurology Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.