Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Vijay Venugopal

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1124438106

Vijay Venugopal is a Family Practice in Manchester, Connecticut. Qualified in 2014, 12 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
12
In the registry since
2014
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Practice location Address checks out

71 Haynes St
Manchester, CT 06040-4131
Phone: (860) 533-4679
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1124438106
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 30, 2014
Last updated in NPPESJune 27, 2025
Mailing address2 Pineberry Ct, Poughkeepsie, NY 12603-4926

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Manchester