Individual provider Active NPI

Tom Paul Vadakara, MD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1255771689
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036140761 Issued in IL
Practice address
600 S Paulina St
Ste 527
Chicago, IL 60612-3806
Phone
(312) 942-5000
NPI assigned
Jun 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD60937807 WA
Psychiatry Physician 2084P0800X 036140761 IL Primary

Addresses

Primary practice location

600 S Paulina St
Ste 527
Chicago, IL 60612-3806

Mailing address

12040 NE 128TH St
Ms-50
Kirkland, WA 98034
Phone (425) 899-1920

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tvadakara17212248@direct.sanfordhealth.org Direct Bozeman Health Deaconess Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60937807WAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bozeman Health Deaconess Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tvadakara17212248@direct.sanfordhealth.org

Organizations & group practices 1

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": "1372464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1255771689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "address_2": "MS-50",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-899-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST",
            "address_2": "STE 527",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADAKARA",
        "first_name": "TOM",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-29",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60937807",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036140761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tvadakara17212248@direct.sanfordhealth.org",
            "affiliation": "Y",
            "affiliationName": "Bozeman Health Deaconess Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "915 Highland Blvd",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597156902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.