Nina Yedavalli, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

036112219 Issued in IL

Practice address

1301 Copperfield Ave
Suite 105
Joliet, IL 60432-2054

Phone

(815) 740-1400

NPI assigned

Sep 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Nina Undevia Other name

Electronic endpoints 1

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

Hematology/OncologyAlso: Internal Medicine, Medical Oncology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
• Macneal Hospital Hospital, Berwyn, IL, CCN 140054
• Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Loyola Medical Group LLC

  • General Practice Physician
  • Berwyn, IL
  • NPI 1376041954
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment Care Compare group NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Loyola University Medical Center

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1609094739

  Hematology & Oncology

  NPD

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

• Gottlieb Community Health Services Corporation

  • General Acute Care Hospital
  • Berwyn, IL
  • NPI 1295710580
  Care Compare affiliation
• Gottlieb Memorial Hospital

  • General Acute Care Hospital
  • Melrose Park, IL
  • NPI 1831170232
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Tinley Park, IL
  • NPI 1427752013
  Care Compare affiliation

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1306094842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 COPPERFIELD AVE",
            "address_2": "SUITE 105",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 COPPERFIELD AVE",
            "address_2": "SUITE 105",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322054",
            "telephone_number": "815-740-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEDAVALLI",
        "first_name": "NINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036112219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nyedavalli93619@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NINA",
            "last_name": "UNDEVIA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Oscar Guillermo Yanes, M.A.
• Ahyun Yang, LSW
• Nelia Yarbrough
• Yatin M Shah MD SC
• Yatin M Shah MD SC
• Ramana Venkata Yedavalli, M.D., M.S.
• Debra Yirku, P.T.
• Jenn-Houng Yo, OTR
• Wendy Yoder
• Eleanor Yonushatis, HEARING DT

• Hematology & Oncology Physician in Joliet, IL
• Providers in Joliet, IL by specialty
• Hematology & Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.