NPIMap

Individual provider Active NPI

Vamsi Krishna Chilluru, M.B.B.S

  • Nephrology Physician
  • Carbondale, IL
National Provider Identifier
1295099406
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036156322 Issued in IL
Practice address
1350 Cedar CT
Carbondale, IL 62901-5336
Phone
(618) 529-2955
Fax
(618) 457-7823
NPI assigned
Jul 2, 2012
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2018010267 MO
Nephrology Physician 207RN0300X 036156322 IL Primary

Addresses

Primary practice location

1350 Cedar CT
Carbondale, IL 62901-5336

Mailing address

1350 Cedar CT
Carbondale, IL 62901-5336
Phone (618) 529-2955

Other practice location 1

1101 W Liberty St
Farmington, MO 63640
Phone (573) 708-1272

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20210816000775 IL Practitioner - NephrologyPractitioner - Internal Medicine 7416242615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney Disease and Medicine Specialty Consultants LLCGroup PAC ID 1052391521, 6 clinicians

Practice addresses (Care Compare)

1350 Cedar CT
Carbondale, IL 62901-5336
Phone (618) 529-2955

1900 State St
Chester, IL 62233-1116
Phone (618) 529-2955

20 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone (618) 529-2955

400 Lincoln Dr
Herrin, IL 62948-3757
Phone (618) 529-2955

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.38 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
75.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Disease and Medicine Specialty Consultants LLC CurrentSince Sep 1, 2021 Accepting new patients
The Metrohealth System Current Accepting new patients

Locations

1350 Cedar Ct
Carbondale, IL 62901
Phone (618) 457-0402

1900 State St
Chester, IL 62233
Phone (618) 826-2388

900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050

20 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 942-7300

400 Lincoln Dr
Herrin, IL 62948
Phone (270) 443-6472

502 W Saint Louis St
West Frankfort, IL 62896
Phone (618) 937-3400

Interoperability endpoints

  • Direct secure messaging: vchilluru104473@direct.metrohealth.org
  • Direct secure messaging: vchilluru290154@direct.carenet.org
  • Direct secure messaging: vchilluru52978@sih.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 10

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": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1295099406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015336",
            "telephone_number": "618-529-2955",
            "fax_number": "618-457-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015336",
            "telephone_number": "618-529-2955",
            "fax_number": "618-457-7823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 W LIBERTY ST",
            "address_purpose": "LOCATION",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "63640",
            "country_code": "US",
            "telephone_number": "573-708-1272",
            "fax_number": "573-756-6807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILLURU",
        "first_name": "VAMSI KRISHNA",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2018010267",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036156322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1101 W LIBERTY ST",
            "city": "FARMINGTON",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.