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VIJAY VENUGOPAL
NPI 1124438106
Student in an Organized Health Care Education/Training Program in Manchester, CT

Active since April 30, 2014PECOS EnrolledAccepts Medicare Assignment
71 HAYNES ST, MANCHESTER, CT 06040(860) 533-4679 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 27, 2025, Feb 11, 2022 (2 updates tracked since 2022).

About Vijay Venugopal NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIJAY VENUGOPAL (NPI 1124438106) is an individual student in an organized health care education/training program in Manchester, Connecticut and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1124438106
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameVIJAY VENUGOPAL
Location Address71 HAYNES STManchester, CT 06040-4131
Mailing Address2 Pineberry CtPoughkeepsie, NY 12603-4926 · (845) 702-4867
Phone(860) 533-4679
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 30, 2014
Last NPPES UpdateJune 27, 20252 updates tracked since enumeration
✔ NPI 1124438106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

71 HAYNES ST, Manchester, CT 06040
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Vijay Venugopal is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729303532
PECOS Enrollment IDI20180119002080
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. FRANKLIN GEORGE GILLIG M.D.
Emergency Medicine
71 HAYNES ST
MANCHESTER, CT 06040
Capitol Planning Region (860) 646-1222
MRS. CORY BERNARD LCSW
Social Worker (Clinical)
71 HAYNES ST, BEHAVIORAL HEALTH UNIT
MANCHESTER, CT 06040
Capitol Planning Region (860) 646-1222
DR. DINESH S. SHAH M.D.
Emergency Medicine
71 HAYNES ST
MANCHESTER, CT 06040
Capitol Planning Region (860) 646-1222
DANIELLE KIREI PA
Physician Assistant
71 HAYNES ST
MANCHESTER, CT 06040
Capitol Planning Region (860) 646-1222
RAJITHA REDDY
Student in an Organized Health Care Education/Training Program
71 HAYNES ST
MANCHESTER, CT 06040
Capitol Planning Region (860) 533-4679
DR. ALLANA R LEE D.O.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
71 HAYNES ST
MANCHESTER, CT 06040
Capitol Planning Region (860) 646-1222
ANDREA LYNCH PA-C
Physician Assistant (Surgical)
71 HAYNES ST
MANCHESTER, CT 06040
Capitol Planning Region (860) 533-6595
JAMSHID A MARVASTI, M.D. P.C.
Psychiatry & Neurology (Psychiatry)
71 HAYNES ST, MMH
MANCHESTER, CT 06040
Capitol Planning Region (860) 643-1166

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vijay Venugopal's NPI number?

The NPI number for Vijay Venugopal is 1124438106. It was assigned to this individual provider in the NPPES registry on April 30, 2014.

Where is Vijay Venugopal located?

Vijay Venugopal practices at 71 Haynes St, Manchester, CT 06040. The listed phone number is (860) 533-4679.

What is Vijay Venugopal's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Vijay Venugopal enrolled in Medicare?

Yes. Vijay Venugopal is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Vijay Venugopal was last updated on June 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.