Goutham Kondapi

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036160201 Issued in IL

Practice address

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441

Phone

(708) 422-7715

Fax

(708) 422-7816

NPI assigned

Apr 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Nephrology

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Associates of Northern Illinois LTDGroup PAC ID 2163328675, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FMC - Merrionette Park Dialysis facility, Merrionette Park, IL, CCN 142667
• Concerto Dialysis Dialysis facility, Lincolnwood, IL, CCN 142655
• FMC - Southside Dialysis Center Dialysis facility, Chicago, IL, CCN 142508
• Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
• Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
• Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gkondapi66701@direct.acumenmd.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nephrology Associates of Northern Illinois, LTD.

  • Nephrology Physician
  • Oak Brook, IL
  • NPI 1124069182
  Medicare reassignment Care Compare group NPD
• Southwest Nephrology Associates, S.C.

  • Ambulatory Surgical Clinic/Center
  • Orland Park, IL
  • NPI 1104925163

  Nephrology

  Medicare reassignment NPD

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

• Renal Care Group Chicago Southside, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Merrionette Park, IL
  • NPI 1710077219

  Dialysis facility

  Care Compare affiliation Name & address match
• WSKC Dialysis Services, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
  • NPI 1922113760

  Dialysis facility

  Care Compare affiliation Name & address match
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Oak Lawn, IL
  • NPI 1548375082
  Care Compare affiliation
• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Evergreen Park, IL
  • NPI 1215572045
  Care Compare affiliation
• Palos Community Hospital

  • Psychiatric Hospital Unit
  • Palos Heights, IL
  • NPI 1184699118
  Care Compare affiliation
• Palos Community Hospital

  • General Acute Care Hospital
  • Palos Heights, IL
  • NPI 1851386692
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  • Rehabilitation Hospital Unit
  • New Lenox, IL
  • NPI 1003933797
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  • General Acute Care Hospital
  • New Lenox, IL
  • NPI 1568553519
  Care Compare affiliation

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1245792175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231557",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 S PULASKI RD",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051441",
            "telephone_number": "708-422-7715",
            "fax_number": "708-422-7816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22201 Moross Rd Ste 50",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362166",
            "country_code": "US",
            "telephone_number": "313-343-7774",
            "fax_number": "313-343-8747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5841 S Maryland Ave # Mc5100",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "773-702-3630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16605 S 107th Court",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "60467",
            "country_code": "US",
            "telephone_number": "708-226-9860",
            "fax_number": "708-226-9864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONDAPI",
        "first_name": "GOUTHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036160201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Nicole Knueven, PA-C
• Kathleen Ann Kociak, RN, MS, GNP-BC
• Mark Anthony Koludrovic, DDS
• Thomas Anthony Koludrovic, DDS
• Emily R Konczal, O.D.
• Elizabeth R Konieczny
• Anne Koronkiewicz, DO
• Bahij Kreidieh
• Christopher Michael Krippinger, PA-C
• Richard C Krueger Jr., M.D., PH.D.

• Nephrology Physician in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.