Individual provider Active NPI

Zaruhi Vardanyan, MD

  • Hospitalist Physician
  • Palos Heights, IL
National Provider Identifier
1083943443
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036129532 Issued in IL
Practice address
12251 S 80TH Ave
Palos Heights, IL 60463-1256
Phone
(708) 923-5869
Fax
(708) 923-5859
NPI assigned
Dec 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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 036.129532 IL
Hospitalist Physician 208M00000X 036129532 IL Primary

Addresses

Primary practice location

12251 S 80TH Ave
Palos Heights, IL 60463-1256

Mailing address

12251 S 80TH Ave
Suite 1630
Palos Heights, IL 60463-1256
Phone (708) 923-5173

Other identifiers 2

IdentifierTypeStateIssuer
F400370648OtherILMEDICARE PTAN
036129532MedicaidIL

Other names 1

  • Zaruhi Mikayelyen Former name

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
I20170323000092 IL Practitioner - HospitalistPractitioner - Internal Medicine 7416140991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone (708) 923-5869

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

Hospital & facility affiliations

  • Palos Community Hospital Hospice Hospice, Lemont, IL, CCN 141591
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.129532ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

15300 West Ave
Orland Park, IL 60462
Phone (708) 226-2440

12251 S 80th Ave
Ste 1630
Palos Heights, IL 60463
Phone (708) 923-5173

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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 3

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": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1083943443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "address_2": "SUITE 1630",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-5173",
            "fax_number": "708-923-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-5869",
            "fax_number": "708-923-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDANYAN",
        "first_name": "ZARUHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.129532",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036129532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400370648",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036129532",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZARUHI",
            "last_name": "MIKAYELYEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.