Suriya Sastri, MDPC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036068118 Issued in IL

Legal business name

SURIYA SASTRI, MDPC

Practice address

6900 S Madison St
Suite 102
Willowbrook, IL 60527-5510

Phone

(630) 325-8684

Fax

(630) 325-2490

NPI assigned

Dec 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Suriya V Sastri, M.D.NPI 1316904816

Title

President

Phone

(630) 325-8684

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JCAABD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suriya Sastri, M.D.

  • Gastroenterology Physician
  • Willowbrook, IL
  • NPI 1316904816
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1023387040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 MADISON STREET",
            "address_2": "SUITE - 102",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "60527",
            "telephone_number": "630-325-8684",
            "fax_number": "630-325-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 S MADISON ST",
            "address_2": "SUITE 102",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275510",
            "telephone_number": "630-325-8684",
            "fax_number": "630-325-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURIYA SASTRI, MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "SASTRI",
        "authorized_official_first_name": "SURIYA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-325-8684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036068118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036068118",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Willowbrook, IL
• Providers in Willowbrook, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.