Individual provider Active NPI

Swetha Kiran Velagapudi

  • Internal Medicine Physician
  • Oak Lawn, IL
National Provider Identifier
1245082023
Registry record updated Jul 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.084185 Issued in IL
Practice address
4220 W 95TH St Ste 200
Oak Lawn, IL 60453-3072
Phone
(708) 398-0287
NPI assigned
Apr 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 125.084185 IL Primary

Addresses

Primary practice location

4220 W 95TH St Ste 200
Oak Lawn, IL 60453-3072

Mailing address

2237 Waterrock Dr
Allen, TX 75013-5532
Phone (630) 450-3826

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
I20250728001049 IL Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 3274040084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.084185ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720310400000",
    "number": "1245082023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2237 WATERROCK DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135532",
            "telephone_number": "630-450-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W 95TH ST STE 200",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533072",
            "telephone_number": "708-398-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAGAPUDI",
        "first_name": "SWETHA",
        "middle_name": "KIRAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.084185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.