Individual provider Active NPI

Sheba Ampalloor, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1023039138
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036099775 Issued in IL
Practice address
500 E 51St St
Provident Hospital of Cook County
Chicago, IL 60615-2400
Phone
(312) 572-1200
Fax
(312) 572-1294
NPI assigned
Jul 22, 2006
Last updated
Apr 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-099775 IL
Emergency Medicine Physician 207P00000X 036099775 IL Primary

Addresses

Primary practice location

500 E 51St St
Provident Hospital of Cook County
Chicago, IL 60615-2400

Mailing address

905 E Kimber LN
Arlington HTS, IL 60005-4320
Phone (847) 427-8834

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sampalloorv@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080103000751 IL Practitioner - Emergency Medicine 9830279785 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036099775ILMDEmergency Medicine Physician
036-099775ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jan 27, 2023 Accepting new patients
Endeavor Health Medical Group Emergency Medicine CurrentSince Jan 27, 2023 Accepting new patients
Cook County Current Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Dec 22, 2019 Accepting new patients
Swedish Covenant Management Services, Inc. Internal Medicine Current Accepting new patients
Cook County Emergency Medicine CurrentSince Nov 4, 2010 Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Swedish Covenant Management Services, Inc Emergency Medicine CurrentSince Dec 22, 2019 Accepting new patients

Locations

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

25706 Network Pl
Chicago, IL 60673

2740 W Foster Ave
Chicago, IL 60625
Phone (773) 293-3510

4909 W Division St
Chicago, IL 60651
Phone (773) 854-8000

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

5145 N California Ave
Chicago, IL 60625
Phone (773) 989-3800

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1023039138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 E KIMBER LN",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600054320",
            "telephone_number": "847-427-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E 51ST ST",
            "address_2": "PROVIDENT HOSPITAL OF COOK COUNTY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152400",
            "telephone_number": "312-572-1200",
            "fax_number": "312-572-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMPALLOOR",
        "first_name": "SHEBA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-099775",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036099775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sampalloorv@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.