Individual provider Active NPI

Harish Venkataraj, MD

  • Gastroenterology Physician
  • Maywood, IL
National Provider Identifier
1306490685
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
125074364 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(082) 163-1457
Fax
(082) 165-4467
NPI assigned
Jul 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.074364 IL
Gastroenterology Physician 207RG0100X 125074364 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave BLDG 2840
Maywood, IL 60153-3328
Phone (082) 163-1457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20250521001045 KY Practitioner - Gastroenterology 2860890092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2501 Kentucky Ave
Paducah, KY 42003-3813
Phone (270) 415-7653

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy27
Upper gastrointestinal (GI) endoscopy for acid reflux60

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.074364ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Internal Medicine CurrentSince May 1, 2025 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince May 1, 2025 Accepting new patients
Loyola University Medical Center Current Accepting new patients

Locations

2160 S 1st Ave
Bldg 2840
Maywood, IL 60153

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

1901 Campus Pl
Louisville, KY 40299
Phone (502) 253-4911

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

2605 Kentucky Ave
Ste 202
Paducah, KY 42003
Phone (270) 415-4690

Interoperability endpoints

  • Direct secure messaging: hvenkataraj130643@direct.luhs.org

Organizations & group practices 4

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 1

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1306490685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE BLDG 2840",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "082-163-1457",
            "fax_number": "708-216-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "082-163-1457",
            "fax_number": "082-165-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATARAJ",
        "first_name": "HARISH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.074364",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "125074364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.