Individual provider Active NPI

Pranjali Vadgaonkar

  • Obstetrics & Gynecology Physician
  • Joliet, IL
National Provider Identifier
1487050654
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036.138648 Issued in IL
Practice address
1106 Neal Ave
Joliet, IL 60433-2548
Phone
(815) 727-8869
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036.138648 IL Primary

Addresses

Primary practice location

1106 Neal Ave
Joliet, IL 60433-2548

Mailing address

1106 Neal Ave
Joliet, IL 60433-2548
Phone (815) 727-8869

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
I20151015000782 IL Practitioner - Obstetrics/Gynecology 6709195696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Northwestern University Feinberg Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1106 Neal Ave
Joliet, IL 60433-2548
Phone (815) 727-8670

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.138648ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Will County Community Health Center CurrentSince Sep 28, 2015 Accepting new patients
Will County Community Health Center CurrentSince Sep 28, 2015 Accepting new patients

Locations

501 Ella Ave
Joliet, IL 60433
Phone (815) 727-8480

1106 Neal Ave
Joliet, IL 60433
Phone (815) 727-5054

Interoperability endpoints

  • Direct secure messaging: pranjali.vadgaonkar.p25@direct.willcounty.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1487050654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 NEAL AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604332548",
            "telephone_number": "815-727-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 NEAL AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604332548",
            "telephone_number": "815-727-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADGAONKAR",
        "first_name": "PRANJALI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.138648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.