Siya Ann Nedumgottil, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036134247 Issued in IL

Practice address

1020 E Ogden Ave
Ste 115
Naperville, IL 60563-8609

Phone

(630) 717-8707

Fax

(630) 717-7603

NPI assigned

Jul 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1194037382",
    "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": "1020 E OGDEN AVE",
            "address_2": "STE 115",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638609",
            "telephone_number": "630-717-8707",
            "fax_number": "630-717-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDUMGOTTIL",
        "first_name": "SIYA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-05",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125058824",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036134247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036134247",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snedumgottil134777@direct.edward.org",
            "affiliation": "N",
            "address_1": "1020 E Ogden Ave",
            "address_2": "Ste 115",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605638609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snedumgottil134777@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "1020 E Ogden Ave",
            "address_2": "Ste 115",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605638609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Navigate Align & Thrive
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• Neal R. Bowen, Psy.D., P.C.
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• Internal Medicine Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.