Prakash Vaidy

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C1-0012808 Issued in DE

Practice address

379 Walmart Dr
Camden, DE 19934-1365

Phone

(302) 387-4343

Fax

(302) 538-6790

NPI assigned

Dec 5, 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 1

Other names 1

• Dr. Prakash Vaidyanathan Other name

Medicare fee-for-service enrollment

Enrolled in DE

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

Specialty

General Surgery

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Responsive Health LLCGroup PAC ID 4183030265, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Responsive Health LLC

  • General Practice Physician
  • Camden, DE
  • NPI 1780273839
  Medicare reassignment Care Compare group NPD
• Responsive Medical LLC

  • General Practice Physician
  • Camden, DE
  • NPI 1811586902
  Medicare reassignment NPD
• David V. Martini, M.D. P.a.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Elkton, MD
  • NPI 1508811928
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1962486761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1040",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219221040",
            "telephone_number": "410-398-0590",
            "fax_number": "443-681-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 WALMART DR",
            "city": "CAMDEN",
            "state": "DE",
            "postal_code": "199341365",
            "telephone_number": "302-387-4343",
            "fax_number": "302-538-6790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "756 S Little Creek Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199014720",
            "country_code": "US",
            "telephone_number": "302-724-6710",
            "fax_number": "302-538-6790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234 New Castle Ave",
            "address_purpose": "LOCATION",
            "city": "New Castle",
            "state": "DE",
            "postal_code": "197202701",
            "country_code": "US",
            "telephone_number": "302-261-6343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAIDY",
        "first_name": "PRAKASH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0051953",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0012808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424400100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRAKASH",
            "last_name": "VAIDYANATHAN",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Beverly Swinton
• Erin Taraboletti
• The Corner Apothecary, Inc (The Corner Apothecary)
• James B Tucker, ATC
• Jennifer Tauras Twining, P.T.
• Robert James Varipapa, M.D.
• Gizelle Suarez Villanueva
• Joseph Christopher Vincent, D.C.
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5039)
• Dona O. Walters

• Family Medicine Physician in Camden, DE
• Providers in Camden, DE by specialty
• Family Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.