NPIMap

Individual provider Active NPI

Venkata L.N.V.K Buddharaju, M.D

  • Nephrology Physician
  • Crystal Lake, IL
National Provider Identifier
1508145327
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036139711 Issued in IL
Practice address
442 N Il Route 31
Apartment
Crystal Lake, IL 60012-3709
Phone
(224) 238-3211
NPI assigned
Aug 10, 2011
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036139711 IL Primary

Addresses

Primary practice location

442 N Il Route 31
Apartment
Crystal Lake, IL 60012-3709

Mailing address

PO Box 3877
Joliet, IL 60434-3877
Phone (815) 741-6830

Other practice location 1

1670 Capital St Unit 900
Elgin, IL 60124-7837
Phone (847) 285-1908

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vbuddharaju236357@direct.myadvocateaurora.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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160517000753 IL Practitioner - NephrologyPractitioner - Internal Medicine 4183913098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney Care Center Elgin LLCGroup PAC ID 2769634252, 8 clinicians

Practice addresses (Care Compare)

1670 Capital St
Suite 900
Elgin, IL 60124-8198
Phone (224) 238-3211

442 N Il Route 31
Crystal Lake, IL 60012-3709
Phone (224) 238-3211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036139711ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Center Elgin LLC Nephrology CurrentSince May 5, 2016 Accepting new patients

Locations

442 N Il Route 31
Crystal Lake, IL 60012
Phone (224) 238-3211

1670 Capital St
Ste 900
Elgin, IL 60124
Phone (224) 214-1943

10370 Haligus Rd
Ste 115
Huntley, IL 60142
Phone (847) 277-0555

1843 W Irving Park Rd
Schaumburg, IL 60193
Phone (847) 285-1908

Interoperability endpoints

  • Direct secure messaging: vbuddharaju236357@direct.myadvocateaurora.org

Organizations & group practices 1

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.

Hospital & facility affiliations 10

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": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1508145327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3877",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604343877",
            "telephone_number": "815-741-6830",
            "fax_number": "815-741-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N IL ROUTE 31",
            "address_2": "APARTMENT",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123709",
            "telephone_number": "224-238-3211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Capital St Unit 900",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601247837",
            "country_code": "US",
            "telephone_number": "847-285-1908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUDDHARAJU",
        "first_name": "VENKATA",
        "middle_name": "L.N.V.K",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036139711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vbuddharaju236357@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "442 N Il Route 31",
            "address_2": "Apartment",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600123709",
            "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": "442 N Il Route 31",
            "address_2": "Apartment",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600123709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.