Kunjumol Pullathra Velayudhan, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209006239 Issued in IL

Practice address

3650 W 95TH St
Evergreen Park, IL 60805-2108

Phone

(708) 422-7715

Fax

(708) 422-7816

NPI assigned

Oct 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skyline Physicians LLCGroup PAC ID 9133367931, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Metropolitan Home Health Care, Inc Home health agency, Wheeling, IL, CCN 147786

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvelayudha@direct.ccprovider.org

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.

• Skyline Physicians LLC

  • Family Medicine Physician
  • Glen Ellyn, IL
  • NPI 1568704443
  Medicare reassignment Care Compare group NPD
• Cook County

  dba John H. Stroger, Jr. Hospital of Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Cook County

  dba Cook County Health & Hospitals System Physician Services

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170
  NPD
• Cook County

  dba Bronzeville Health Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD
• John H Stroger Jr Hospital Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1992914733
  NPD (past)
• M & F Medical Services, LTD

  • Adult Medicine Physician
  • Chicago, IL
  • NPI 1447666318
  NPD (past)
• Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1114139946

  Adult Health

  NPD (past)
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700
  NPD (past)

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

• Metropolitan Home Health Care Inc

  • Home Health Agency
  • Glenview, IL
  • NPI 1790778348
  Care Compare affiliation

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1124215264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052108",
            "telephone_number": "708-422-7715",
            "fax_number": "708-422-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052108",
            "telephone_number": "708-422-7715",
            "fax_number": "708-422-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAYUDHAN",
        "first_name": "KUNJUMOL",
        "middle_name": "PULLATHRA",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209006239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valentin Berman MD PC
• Valentine Home Health Care Inc
• Ourania Vassiliou, RPH
• Melissa A Vazquez, PHARMD
• Samantha Marie Vazquez, LCPC
• Anna Maria Velazquez, RDN
• Rachel Vetter, FNP
• Arnulfo Vielgo, M.D.
• Village of Evergreen Park
• Dena Vincent, CRNA

• Adult Health Nurse Practitioner in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.