Mahableshwar Vassant Palondikar, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-051040 Issued in IL

Practice address

4160 RFD
Suite 306
Long Grove, IL 60047-9583

Phone

(847) 634-2333

Fax

(847) 634-1132

NPI assigned

Jan 24, 2007

Last updated

Oct 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpalondikar12469@direct.northshore.org

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Family Medicine

  Medicare reassignment NPD
• M Palondikar MD PC

  • Family Medicine Physician
  • Long Grove, IL
  • NPI 1700904448
  NPD (past) Authorized official
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1447305743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 CRYSTAL WAY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600122226",
            "telephone_number": "847-634-2333",
            "fax_number": "847-634-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 RFD",
            "address_2": "SUITE 306",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600479583",
            "telephone_number": "847-634-2333",
            "fax_number": "847-634-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALONDIKAR",
        "first_name": "MAHABLESHWAR",
        "middle_name": "VASSANT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-051040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpalondikar12469@direct.northshore.org",
            "affiliation": "N",
            "address_1": "650 W Lake Cook Rd",
            "city": "Buffalo Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600892082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Luisa A Orrico, M.D.
• Jenna Elise Ortega, OTD
• Craig William Oswald, D.C.
• Kimberly Lynn Oswald, L.M.T.
• Teresa Joanna Overson, NP
• Nisha Patel, APN
• Priyanka Patel, NP
• Trushar Patel, ACNP
• Amy L Peters, PHARMD
• Ritu Piplani, M.D.

• Family Medicine Physician in Long Grove, IL
• Providers in Long Grove, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.