Individual provider Active NPI

Lekshmi R Venugopal, M.D.

  • Psychiatry Physician
  • St Charles, IL
National Provider Identifier
1164682597
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-118180 Issued in IL
Practice address
3805 E Main St Ste M
St Charles, IL 60174-2487
Phone
(630) 646-5200
Fax
(630) 377-3762
NPI assigned
Jun 10, 2008
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-118180 IL Primary

Addresses

Primary practice location

3805 E Main St Ste M
St Charles, IL 60174-2487

Mailing address

3805 E Main St Ste M
St Charles, IL 60174-2487
Phone (630) 646-5200

Other identifiers 2

IdentifierTypeStateIssuer
2220936OtherILBCBS
036118180 1MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lvenugopal15513@direct.edward.org 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
I20080718000518 IL Practitioner - PsychiatryPractitioner - Addiction Medicine 9335212695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-118180ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures Psychiatry CurrentSince Aug 11, 2008 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Edward Health Ventures CurrentSince Aug 11, 2008 Accepting new patients
Edward Health Ventures Psychiatry Past Accepting new patients
Edward Health Ventures Psychiatry Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Psychiatry Past Accepting new patients
Edward Health Ventures Psychiatry Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

1120 E Main St
St Charles, IL 60174
Phone (630) 377-6613

3805 E Main St
Ste M
St Charles, IL 60174
Phone (630) 646-5200

Interoperability endpoints

  • Direct secure messaging: lvenugopal15513@direct.edward.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1164682597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 E MAIN ST STE M",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742487",
            "telephone_number": "630-646-5200",
            "fax_number": "630-377-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 E MAIN ST STE M",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742487",
            "telephone_number": "630-646-5200",
            "fax_number": "630-377-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENUGOPAL",
        "first_name": "LEKSHMI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-118180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2220936",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036118180 1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvenugopal15513@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3805 E Main St Ste M",
            "city": "St Charles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601742487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.