Individual provider Active NPI

Vishal Kwatra, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1104439751
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD495614 Issued in PA
Practice address
1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone
(773) 257-5077
Fax
(773) 257-6027
NPI assigned
Aug 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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 125.075469 IL
Internal Medicine Physician 207R00000X MD495614 PA Primary

Addresses

Primary practice location

1500 S Fairfield Ave
Chicago, IL 60608-1782

Mailing address

1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (773) 257-5077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231111000045 VA Practitioner - Internal Medicine 8224485339 Reassigns benefits to 1 organization
I20260604002991 PA Practitioner - Internal Medicine 8224485339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity-Virginia Hospitalists PCGroup PAC ID 6507245131, 109 clinicians

Practice addresses (Care Compare)

1500 N 28TH St
Richmond, VA 23223-5332
Phone (804) 225-1700

Hospital & facility affiliations

  • Bon Secours Richmond Community Hospital Hospital, Richmond, VA, CCN 490094

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.075469ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Virginia Hospitalists PC CurrentSince Oct 26, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

1500 N 28th St
Richmond, VA 23223
Phone (804) 225-1700

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 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": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1104439751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "773-257-5077",
            "fax_number": "773-257-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "773-257-5077",
            "fax_number": "773-257-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWATRA",
        "first_name": "VISHAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.075469",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD495614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.