Individual provider Active NPI

Bindu Lakshmi Gandhiraj, M.D.

  • Psychiatry Physician
  • Aurora, IL
National Provider Identifier
1063562080
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036114054 Issued in IL
Practice address
400 N Highland Ave
Aurora, IL 60506-3814
Phone
(630) 892-4355
Fax
(630) 482-8162
NPI assigned
Jan 11, 2007
Last updated
Jul 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036114054 IL Primary

Addresses

Primary practice location

400 N Highland Ave
Aurora, IL 60506-3814

Mailing address

400 N Highland Ave
Aurora, IL 60506-3814
Phone (630) 892-4355

Other practice location 1

385 Wirtz Drive
NIU Health Services
Dekalb, IL 60115-2879
Phone (815) 753-1311

Other identifiers 1

IdentifierTypeStateIssuer
036114054MedicaidIL

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
I20070726000289 IL Practitioner - Psychiatry 6002917671 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vna Health CareGroup PAC ID 6901879311, 20 clinicians

Practice addresses (Care Compare)

400 N Highland Ave
Aurora, IL 60506-3814
Phone (630) 978-2532

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036114054ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vna Health Care CurrentSince Oct 14, 2013 Accepting new patients
Vna Health Care CurrentSince Oct 14, 2013 Accepting new patients

Locations

400 N Highland Ave
Aurora, IL 60506

400 N Highland Ave
Fl 2
Aurora, IL 60506

Interoperability endpoints

  • Direct secure messaging: bgandhiraj586294@direct.ochin.org

Organizations & group practices 3

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1063562080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063814",
            "telephone_number": "630-892-4355",
            "fax_number": "630-482-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063814",
            "telephone_number": "630-892-4355",
            "fax_number": "630-482-8162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "385 Wirtz Drive",
            "address_2": "NIU Health Services",
            "address_purpose": "LOCATION",
            "city": "Dekalb",
            "state": "IL",
            "postal_code": "601152879",
            "country_code": "US",
            "telephone_number": "815-753-1311",
            "fax_number": "847-753-9599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHIRAJ",
        "first_name": "BINDU",
        "middle_name": "LAKSHMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036114054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114054",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.