VASANTHA KONDAMUDI (MD) – Family Medicine Physician, NPI 1144238924
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
643 GERIATRIC MEDICINE in NY
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Provider Addresses for VASANTHA KONDAMUDI (MD)
Bakley Terrace, Pleasantdale, West Orange, Essex County, New Jersey, 07021, United States
WEST ORANGE, NJ 070522169
Phone: (718) 250-8817
Fax: (718) 250-6609
Type: Mailing
Brooklyn Hospital Center, 121, DeKalb Avenue, Fort Greene, Brooklyn, Kings County, New York, 11201, United States
FAMILY PRACTICE
BROOKLYN, NY 112015425
Phone: (718) 250-8817
Fax: (718) 250-8878
Type: Location
3 UNIVERSITY PLZ STE 205
HACKENSACK, NJ 076016208
Phone: (201) 833-3000
Type: Mailing
718 TEANECK RD
TEANECK, NJ 076664245
Phone: (201) 833-3000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-12-14
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040312000688 | I | Family Practice | NJ | TBD |
| I20111214000947 | I | Family Practice | NY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 07052)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | NJ | |
| Internal Medicine | NJ | |
| U R O L O G Y | PA | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | FL | |
| - | AR | |
| - | NJ | |
| General Surgery | NJ | |
| - | NJ | |
| Nurse Practitioner | NJ |
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