Vasundhara-Devi Vemula, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

C145223 Issued in CA

Practice address

810 5TH Ave Ste 100
San Rafael, CA 94901-3252

Phone

(415) 994-9906

Fax

(415) 295-7080

NPI assigned

Sep 20, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Dr. Vasu Vemula Other name

Medicare fee-for-service enrollment

Enrolled in KY, CA2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Abs Lincs Ky, LLC.Group PAC ID 6608833520, 12 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 and National Provider Directory roles.

• Abs Lincs Ky, LLC

  • Psychiatry Physician
  • Hopkinsville, KY
  • NPI 1720353501
  Medicare reassignment Care Compare group NPD
• Comprehensive Psychiatric Services, a Medical Group

  • Psychiatry Physician
  • Walnut Creek, CA
  • NPI 1184785834
  Medicare reassignment NPD
• County of Butte

  • Adult Mental Health Clinic/Center
  • Chico, CA
  • NPI 1578623583
  Medicare reassignment NPD
• County of Butte

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paradise, CA
  • NPI 1174161343
  NPD
• County of Butte

  • Adult Mental Health Clinic/Center
  • Chico, CA
  • NPI 1992248132
  NPD
• Side by Side

  • Community/Behavioral Health Agency
  • San Rafael, CA
  • NPI 1457742835
  NPD

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1972599405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 BUTTERFIELD RD",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601222",
            "telephone_number": "415-994-9906",
            "fax_number": "415-295-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 5TH AVE STE 100",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013252",
            "telephone_number": "415-994-9906",
            "fax_number": "415-295-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEMULA",
        "first_name": "VASUNDHARA-DEVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C145223",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "C145223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64067812",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY LICENSE #",
            "identifier": "37984",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK LICENSE #",
            "identifier": "177740",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "C145223",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VASU",
            "last_name": "VEMULA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dallas Marie Vazquez
• Harish Veerapalli
• Maria G. Vega
• Tracy Marie Vega, LCSW
• Natrada Vejjadham
• Jennifer D Venezia
• Jaimalynne Ventura
• Cynthia Lynn Vergara, M.S., MFT
• Vericare of California Medical Group
• Verity Physical Therapy & Wellness

• Child & Adolescent Psychiatry Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.