| Vasp Professional Services LLC | |
|
15200 Shady Grove Rd Ste 205 Rockville MD 20850-6228 | |
| (240) 676-9900 | |
| Not Available |
| Full Name | Vasp Professional Services LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 15200 Shady Grove Rd Ste 205, Rockville, Maryland |
| Authorized Official Name and Position | Vijaya Kommineni (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2406769900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vasp Professional Services LLC 15504 Hallman Grove Ct North Potomac MD 20878-3474 Ph: (240) 676-9900 | Vasp Professional Services LLC 15200 Shady Grove Rd Ste 205 Rockville MD 20850-6228 Ph: (240) 676-9900 |
| NPI Number | 1770445710 |
|---|---|
| Provider Enumeration Date | 11/28/2025 |
| Last Update Date | 01/14/2026 |
| Certification Date | 01/14/2026 |
| Medicare PECOS PAC ID | 6800374950 |
|---|---|
| Medicare Enrollment ID | O20260129003360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770445710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Vijaya K Kommineni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407019326 PECOS PAC ID: 4082884598 Enrollment ID: I20120716000433 |
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