Individual provider Active NPI

Ashruta J Patel, MD

  • Internal Medicine Physician
  • Glen Ellyn, IL
National Provider Identifier
1164451696
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036108696 Issued in IL
Practice address
430 Pennsylvania Ave Ste 310
Glen Ellyn, IL 60137-4464
Phone
(630) 790-1792
Fax
(630) 545-7568
NPI assigned
Jun 30, 2006
Last updated
Feb 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036108696 IL Primary

Addresses

Primary practice location

430 Pennsylvania Ave Ste 310
Glen Ellyn, IL 60137-4464

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

6834 W Cermak Rd
Berwyn, IL 60402-2240
Phone (708) 788-6270

Other identifiers 2

IdentifierTypeStateIssuer
1164451696OtherILNPI
036108696MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apatel266074@dulyhealthandcare.direct-ci.com Direct

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
I20050304000751 IL Practitioner - Internal Medicine 6507810280 Reassigns benefits to 1 organization
Practice locations: Berwyn, IL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Dupage Medical Group LTD CurrentSince Feb 12, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince Feb 12, 2024 Accepting new patients
Wheaton Internal Medicine, LTD. Internal Medicine PastSince Feb 11, 2024 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

430 Pennsylvania Ave
Glen Ellyn, IL 60137
Phone (630) 545-7576

430 Pennsylvania Ave
Ste 310
Glen Ellyn, IL 60137
Phone (630) 790-1792

Interoperability endpoints

  • Direct secure messaging: apatel266074@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: apatel50924@direct.luhs.org

Organizations & group practices 4

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 4

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1164451696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 PENNSYLVANIA AVE STE 310",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374464",
            "telephone_number": "630-790-1792",
            "fax_number": "630-545-7568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6834 W Cermak Rd",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604022240",
            "country_code": "US",
            "telephone_number": "708-788-6270",
            "fax_number": "708-788-6271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ASHRUTA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036108696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164451696",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108696",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apatel266074@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "430 Pennsylvania Ave Ste 310",
            "city": "Glen Ellyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601374464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

Verify at the official NPI Registry.