Individual provider Active NPI

Amrit Mangat, M.D.

  • Surgery Physician
  • Glen Ellyn, IL
National Provider Identifier
1053455386
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036-102386 Issued in IL
Practice address
430 Pennsylvania Ave
Suite 350
Glen Ellyn, IL 60137-4464
Phone
(630) 790-1700
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036-102386 IL Primary

Addresses

Primary practice location

430 Pennsylvania Ave
Suite 350
Glen Ellyn, IL 60137-4464

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018

Other identifiers 2

IdentifierTypeStateIssuer
036102386MedicaidIL
P00749996OtherILRR MEDICARE

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
I20040818000269 IL Practitioner - General Surgery 8224001383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

Hospital & facility affiliations

  • Edward Hospital Hospital, Naperville, IL, CCN 140231

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-102386ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Sep 8, 2008 Accepting new patients
Dupage Medical Group LTD CurrentSince Sep 8, 2008 Accepting new patients
L.E. McNeill, MD SC Past Accepting new patients
DMG Surgical Center LLC Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

430 Pennsylvania Ave
Ste 350
Glen Ellyn, IL 60137
Phone (630) 545-7660

430 Pennsylvania Ave
Glen Ellyn, IL 60137
Phone (630) 545-7576

430 Warrenville Rd
Ste 310
Lisle, IL 60532
Phone (630) 548-0408

2725 Technology Dr
Lombard, IL 60148
Phone (630) 348-3300

Interoperability endpoints

  • Direct secure messaging: amangat1418@dulyhealthandcare.direct-ci.com

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1053455386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 PENNSYLVANIA AVE",
            "address_2": "SUITE 350",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374464",
            "telephone_number": "630-790-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAT",
        "first_name": "AMRIT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-102386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102386",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00749996",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

Verify at the official NPI Registry.