Individual provider Active NPI

Puja Mehrotra, MD

  • Pediatrics Physician
  • Barrington, IL
National Provider Identifier
1093917130
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-117144 Issued in IL
Practice address
450 W Highway 22
Barrington, IL 60010-1919
Phone
(847) 842-4120
Fax
(847) 842-4421
NPI assigned
Jun 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-117144 IL Primary

Addresses

Primary practice location

450 W Highway 22
Barrington, IL 60010-1919

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

801 S Washington St
Naperville, IL 60540
Phone (630) 527-5197

Other identifiers 1

IdentifierTypeStateIssuer
036117144 1MedicaidIL

Other names 1

  • Puja Jain Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pmehrotra234337@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20100507000007 IL Practitioner - Pediatric Medicine 4981732203 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-117144ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jan 20, 2010 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 20, 2010 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

29373 Network Pl
Chicago, IL 60673

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Interoperability endpoints

  • Direct secure messaging: pmehrotra234337@direct.myadvocateaurora.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1093917130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W HIGHWAY 22",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600101919",
            "telephone_number": "847-842-4120",
            "fax_number": "847-842-4421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 S Washington St",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "60540",
            "country_code": "US",
            "telephone_number": "630-527-5197",
            "fax_number": "630-527-3797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHROTRA",
        "first_name": "PUJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-117144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117144 1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmehrotra234337@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "450 W Highway 22",
            "city": "Barrington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600101919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "450 W Highway 22",
            "city": "Barrington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600101919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PUJA",
            "last_name": "JAIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Barrington, IL

Sources for this page

Verify at the official NPI Registry.