NPIMap

Individual provider Active NPI

Nimmi Rajagopal

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1063524676
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036112419 Issued in IL
Practice address
4800 W Chicago Ave
Chicago, IL 60651-3226
Phone
(773) 826-9600
NPI assigned
Aug 31, 2006
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036112419 IL Primary

Addresses

Primary practice location

4800 W Chicago Ave
Chicago, IL 60651-3226

Mailing address

1950 W Polk St Ste 7808
Chicago, IL 60612-3723
Phone (312) 413-8170

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nimmi.rajagopal@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060208000625 IL Practitioner - Family Practice 9830104108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince May 4, 2010 Accepting new patients
The Board of Trustees of the University of Illinois Family Medicine CurrentSince May 4, 2010 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cook County Current Accepting new patients
Cook County Family Medicine CurrentSince Jun 21, 2019 Accepting new patients
Cook County CurrentSince Jun 21, 2019 Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

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

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

2045 W Washington Blvd
#698
Chicago, IL 60612

4800 W Chicago Ave
Chicago, IL 60651
Phone (773) 331-1051

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

722 W Maxwell St
#235
Chicago, IL 60607
Phone (312) 433-4114

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

Interoperability endpoints

  • Direct secure messaging: nimmi.rajagopal@direct.ccprovider.org

Organizations & group practices 7

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.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1063524676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 W POLK ST STE 7808",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-413-8170",
            "fax_number": "312-864-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606513226",
            "telephone_number": "773-826-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAGOPAL",
        "first_name": "NIMMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036112419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nimmi.rajagopal@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.