Individual provider Active NPI

Ahanth Vedantham, DPM

  • Podiatrist
  • Westchester, IL
National Provider Identifier
1124605712
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016006047 Issued in IL
Practice address
1943 S Mannheim Rd
Westchester, IL 60154-4322
Phone
(773) 665-3000
NPI assigned
Mar 28, 2021
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016006047 IL Primary

Addresses

Primary practice location

1943 S Mannheim Rd
Westchester, IL 60154-4322

Mailing address

2619 W Berwyn Ave Apt 3
Chicago, IL 60625-3359

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240130001664 IL Practitioner - Podiatry 4880047513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle CenterGroup PAC ID 4789774852, 3 clinicians

Practice addresses (Care Compare)

117 W Lake St
Bloomingdale, IL 60108-1006
Phone (630) 582-3338

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue212
Removal of skin lesions1-10
Removal of nail tissue930
Removal or shaving of skin growth929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Center CurrentSince Jul 1, 2024 Accepting new patients
MD @ Home Illinois, SC CurrentSince Jan 16, 2024 Accepting new patients

Locations

117 W Lake St
Bloomingdale, IL 60108
Phone (630) 351-0222

2003 W Fulton St
Ste 303
Chicago, IL 60612
Phone (312) 243-2223

1943 S Mannheim Rd
Westchester, IL 60154
Phone (708) 352-3338

Interoperability endpoints

  • Direct secure messaging: ahanth.vedantham.1@3342.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1124605712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 W BERWYN AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1943 S MANNHEIM RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601544322",
            "telephone_number": "773-665-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDANTHAM",
        "first_name": "AHANTH",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016006047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westchester, IL

Sources for this page

Verify at the official NPI Registry.