NPIMap

Individual provider Active NPI

Surendra B Avula, MD

  • Cardiovascular Disease Physician
  • Oak Lawn, IL
National Provider Identifier
1275526071
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036-082117 Issued in IL
Practice address
4950 W 95TH St
Oak Lawn, IL 60453-2504
Phone
(708) 576-8150
Fax
(708) 576-8831
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 036082117 IL
Cardiovascular Disease Physician 207RC0000X 036-082117 IL Primary

Addresses

Primary practice location

4950 W 95TH St
Oak Lawn, IL 60453-2504

Mailing address

4950 W 95TH St
Oak Lawn, IL 60453-2504
Phone (708) 576-8150

Other practice location 1

15300 West Ave Ste 23
Orland Park, IL 60462-4504
Phone (708) 923-4200

Other identifiers 4

IdentifierTypeStateIssuer
060053845OtherILPALMETTO GBA INDIVIDUAL #
036082117MedicaidIL
CI8250OtherILPALMETTO GBA GROUP #
21622931OtherILBCBS GROUP #

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address savula277427@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040625000036 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 6507854270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Care Consultants S.C.Group PAC ID 8527229897, 4 clinicians

Practice addresses (Care Compare)

4950 W 95TH St
Oak Lawn, IL 60453-2504
Phone (708) 576-8150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting67
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-082117ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Care Consultants S.C. Cardiovascular Disease CurrentSince Jan 1, 2012 Accepting new patients
Cardiac Imaging Inc CurrentSince Mar 1, 2026 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2024 Accepting new patients
Midamerica Cardiovascular Consultants, LTD Cardiovascular Disease Past Accepting new patients
High Technology Inc Past Accepting new patients
High Technology, Inc. PastSince Sep 1, 2006 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

4950 W 95th St
Oak Lawn, IL 60453
Phone (708) 576-8150

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

15300 West Ave
Ste 23
Orland Park, IL 60462
Phone (708) 576-8150

15300 West Ave
Orland Park, IL 60462
Phone (708) 226-2440

15300 West Ave
Ste 100
Orland Park, IL 60462
Phone (708) 226-2500

15300 West Ave
Ste 206
Orland Park, IL 60462

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBEIBA/Endpoint/CBEIBA
  • Direct secure messaging: savula277427@direct.myadvocateaurora.org

Organizations & group practices 7

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1275526071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532504",
            "telephone_number": "708-576-8150",
            "fax_number": "708-576-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532504",
            "telephone_number": "708-576-8150",
            "fax_number": "708-576-8831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15300 West Ave Ste 23",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604624504",
            "country_code": "US",
            "telephone_number": "708-923-4200",
            "fax_number": "708-923-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVULA",
        "first_name": "SURENDRA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036082117",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-082117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA INDIVIDUAL #",
            "identifier": "060053845",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036082117",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA GROUP #",
            "identifier": "CI8250",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "21622931",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "savula277427@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4950 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4950 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.