Individual provider Active NPI

Vijaya V. Vellanki, M.D.

  • Psychiatry Physician
  • Honolulu, HI
National Provider Identifier
1972691590
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD-12326 Issued in HI
Practice address
1100 Ward Ave
Suite 840
Honolulu, HI 96814-1600
Phone
(808) 522-4521
Fax
(808) 522-3526
NPI assigned
Oct 10, 2006
Last updated
Sep 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD-12326 HI Primary

Addresses

Primary practice location

1100 Ward Ave
Suite 840
Honolulu, HI 96814-1600

Mailing address

1100 Ward Ave
Suite 840
Honolulu, HI 96814-1600
Phone (808) 522-4521

Other identifiers 11

IdentifierTypeStateIssuer
564080 01MedicaidHI
569562OtherHIUHA - KAHI MOHALA
990298651-96706-G006OtherHITRICARE - KAHI MOHALA
MD12326-01OtherHIMDX HAWAII - STRAUB
00A0251643OtherHIHMSA - STRAUB
56408002OtherHIALOHA CARE - STRAUB
5695444OtherHIUHA - STRAUB
0000251645OtherHIHMSA - KAHI MOHALA
564080 02MedicaidHI
56408001OtherHIALOHA CARE - KAHI MOHALA
MD12326OtherHIMDX HAWAII - KAHI MOHALA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20050414000505 HI Practitioner - Psychiatry 9638116254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

1100 Ward Ave
Suite 840
Honolulu, HI 96814-1610
Phone (808) 522-4521

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Sep 1, 2005 Accepting new patients
Straub Clinic & Hospital CurrentSince Sep 1, 2005 Accepting new patients

Locations

1100 Ward Ave
Ste 840
Honolulu, HI 96814
Phone (808) 522-4000

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1972691590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WARD AVE",
            "address_2": "SUITE 840",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141600",
            "telephone_number": "808-522-4521",
            "fax_number": "808-522-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WARD AVE",
            "address_2": "SUITE 840",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141600",
            "telephone_number": "808-522-4521",
            "fax_number": "808-522-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELLANKI",
        "first_name": "VIJAYA",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-12326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "564080 01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA - KAHI MOHALA",
            "identifier": "569562",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE - KAHI MOHALA",
            "identifier": "990298651-96706-G006",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDX HAWAII - STRAUB",
            "identifier": "MD12326-01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA - STRAUB",
            "identifier": "00A0251643",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALOHA CARE - STRAUB",
            "identifier": "56408002",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA - STRAUB",
            "identifier": "5695444",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA - KAHI MOHALA",
            "identifier": "0000251645",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "564080 02",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALOHA CARE - KAHI MOHALA",
            "identifier": "56408001",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDX HAWAII - KAHI MOHALA",
            "identifier": "MD12326",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.