Indravadan Vyas, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

MD2016-0003 Issued in NM

Practice address

201 Cedar St SE Ste 4660
Albuquerque, NM 87106-4924

Phone

(505) 563-6530

Fax

(505) 563-6336

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1942299888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE STE 4660",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064924",
            "telephone_number": "505-563-6530",
            "fax_number": "505-563-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "INDRAVADAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0084182",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NM",
            "license": "MD2016-0003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264836900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32756526",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mien Vu
• Tracy Thuy Vu, PA
• Zao Charles Vu, MD
• Duc C Vuong, M.D.
• Mimi Vuong
• W Gregory Rose DDS PA
• Kimberly Joy Waack, PA-C
• Richard A. Wachs, M.D.
• David Wachter, MD
• Meredith J Wachter

• Pediatric Surgery Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pediatric Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.