Madhavi Manubolu, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036115243 Issued in IL

Practice address

1331 W 75TH St Ste 202
Naperville, IL 60540-9311

Phone

(630) 305-3025

Fax

(630) 995-3876

NPI assigned

Nov 22, 2006

Last updated

Feb 25, 2021By the provider in NPPES

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

Other identifiers 1

Other names 1

• Madhavi Manubolu Professional name

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward Hospital Hospital, Naperville, IL, CCN 140231
• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Allergy & Immunology Physician
  • Evanston, IL
  • NPI 1497701882

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Edward Health Ventures

  • Specialist
  • Naperville, IL
  • NPI 1447501879
  NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Anjali Kher, M.D., S.C.

  • Pediatrics Physician
  • Plainfield, IL
  • NPI 1851501498
  NPD (past)
• Edward Health Ventures

  dba Edward Medical Group

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1790735744
  NPD (past)
• Spectrum Family Medicine, S.C.

  • Family Medicine Physician
  • Naperville, IL
  • NPI 1134318835
  NPD (past)
• Women's Doc of Elgin, S. C.

  • Obstetrics & Gynecology Physician
  • Elgin, IL
  • NPI 1295763886

  Family Medicine

  NPD (past)

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

• Edward Hospital

  dba Endeavor Health Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation
• Elmhurst Memorial Hospital

  dba Endeavor Health Elmhurst Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1194890459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 W 75TH ST STE 202",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605409311",
            "telephone_number": "630-305-3025",
            "fax_number": "630-995-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W 75TH ST STE 202",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605409311",
            "telephone_number": "630-305-3025",
            "fax_number": "630-995-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUBOLU",
        "first_name": "MADHAVI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036115243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115243",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmanubolu21556@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mmanubolu21556@direct.edward.org",
            "address_1": "1331 W 75th St Ste 202",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605409311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MADHAVI",
            "last_name": "MANUBOLU",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Manor Care of Naperville Il LLC (ManorCare Health Services-Naperville)
• Callista Anastasia Manos, ATC
• Mary Marguerite Manseau, APN-CNP
• Kathleen Marie Mansour, M.D.
• Jessica Mantovani
• Christy L Manuel, PT
• Marina Ann Many
• Jamie Mapel, MS, CCC-SLP
• Maple Park Dental Care, P.C.
• Maplebrook Chiropractic LLC

• Family Medicine Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.