Individual provider Active NPI

Vaishnavi Gurumurthy

  • Student in an Organized Health Care Education/Training Program
  • Elizabeth, NJ
National Provider Identifier
1972281194
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
100 Union St Unit 406
Elizabeth, NJ 07202-2166
Phone
(908) 267-4805
NPI assigned
Jul 7, 2023
Last updated
May 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Nephrology Physician 207RN0300X MT236662 PA

Addresses

Primary practice location

100 Union St Unit 406
Elizabeth, NJ 07202-2166

Mailing address

3509 N Broad St
Philadelphia, PA 19140-4105

Other practice location 1

3509 N Broad St Ste 226
Philadelphia, PA 19140-4105
Phone (215) 707-3829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20260527003419 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8224508668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT236662PAMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1972281194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 UNION ST UNIT 406",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022166",
            "telephone_number": "908-267-4805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3509 N Broad St Ste 226",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191404105",
            "country_code": "US",
            "telephone_number": "215-707-3829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GURUMURTHY",
        "first_name": "VAISHNAVI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MT236662",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.