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DR. VASUNDHARA-DEVI VEMULA M.D.
NPI 1972599405
Psychiatry & Neurology - Child & Adolescent Psychiatry in San Rafael, CA

Active since September 20, 2005PECOS EnrolledAccepts Medicare Assignment
810 5TH AVE STE 100, SAN RAFAEL, CA 94901(415) 994-9906(415) 295-7080 Get Directions Write a Review

NPPES record last updated: September 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 29, 2023, Aug 25, 2023, Mar 8, 2023 and 7 more (10 updates tracked since 2016).

About Dr. Vasundhara-devi Vemula M.d. NPPES

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

DR. VASUNDHARA-DEVI VEMULA M.D. (NPI 1972599405) is an individual child & adolescent psychiatry provider in San Rafael, California, licensed in California (C145223) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1980).

NPPES Registry Identity

NPI1972599405
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. VASUNDHARA-DEVI VEMULACredential: M.D.
Location Address810 5TH AVE STE 100San Rafael, CA 94901-3252
Mailing Address365 Butterfield RdSan Anselmo, CA 94960-1222 · (415) 994-9906 · Fax (415) 295-7080
Phone(415) 994-9906
Fax(415) 295-7080
Sole ProprietorYes
Medical School CMSOtherGraduated 1980
Enumeration DateSeptember 20, 2005
Last NPPES UpdateSeptember 28, 202310 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2023
✔ NPI 1972599405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in CA · C145223
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License C145223 (CA)
810 5TH AVE STE 100, San Rafael, CA 94901
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Other Names 1

Other Name (5)Dr. Vasu Vemula M.d.

Other Identifiers 4

Medicaid64067812KY
Other37984KY · Kentucky License #
Other177740NY · New York License #
OtherC145223CA · California Medical License

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

Dr. Vasundhara-devi Vemula M.d. 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 ID4385806611
PECOS Enrollment IDI20120503000376
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 3

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

ALYSSA IVETTE MARTINEZ
Peer Specialist
810 5TH AVE STE 100
SAN RAFAEL, CA 94901
Marin County (415) 996-3957
SIDE BY SIDE
Community/Behavioral Health
810 5TH AVE STE 100
SAN RAFAEL, CA 94901
Marin County (415) 870-9298
LISA OCHOA
Peer Specialist
810 5TH AVE STE 100
SAN RAFAEL, CA 94901
Marin County (415) 720-3965

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 Vasundhara-devi Vemula's NPI number?

The NPI number for Vasundhara-devi Vemula is 1972599405. It was assigned to this individual provider in the NPPES registry on September 20, 2005. The provider is also known as Dr. Vasu Vemula M.D..

Where is Vasundhara-devi Vemula located?

Vasundhara-devi Vemula practices at 810 5th Ave Ste 100, San Rafael, CA 94901. The listed phone number is (415) 994-9906.

What is Vasundhara-devi Vemula's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Vasundhara-devi Vemula enrolled in Medicare?

Yes. Vasundhara-devi Vemula 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 Vasundhara-devi Vemula was last updated on September 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.