Individual provider Active NPI

Vijeta Reddy Pamudurthy, D.O.

  • Gastroenterology Physician
  • Niles, IL
National Provider Identifier
1326429333
Registry record updated Dec 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036.157040 Issued in IL
Practice address
7900 N Milwaukee Ave Ste 19
Niles, IL 60714-3239
Phone
(815) 928-6274
NPI assigned
Jun 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036.157040 IL Primary

Addresses

Primary practice location

7900 N Milwaukee Ave Ste 19
Niles, IL 60714-3239

Mailing address

7900 N Milwaukee Ave Ste 19
Niles, IL 60714-3239
Phone (847) 318-9595

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vpamudurthy310875@directmyadvocateaurora.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: 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
I20210806001127 IL Practitioner - Gastroenterology 1153666763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Midwestern University, Chicago College of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7900 N Milwaukee Ave
Suite 19
Niles, IL 60714-3239
Phone (847) 318-9595

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy89
Upper gastrointestinal (GI) endoscopy for acid reflux109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.157040ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 30, 2021 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 30, 2021 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

7900 N Milwaukee Ave
Ste 19
Niles, IL 60714
Phone (847) 318-9595

Interoperability endpoints

  • Direct secure messaging: vpamudurthy310875@direct.myadvocateaurora.org

Organizations & group practices 3

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639872000000",
    "number": "1326429333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE STE 19",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143239",
            "telephone_number": "847-318-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE STE 19",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143239",
            "telephone_number": "815-928-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMUDURTHY",
        "first_name": "VIJETA",
        "middle_name": "REDDY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2021-12-19",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.157040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vpamudurthy310875@directmyadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7900 N Milwaukee Ave Ste 19",
            "city": "Niles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607143239",
            "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": "7900 N Milwaukee Ave Ste 19",
            "city": "Niles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607143239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.