Active NPI
Nittor R Jayaram, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Orland Park, IL
National Provider Identifier
1508935222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 036.056518
- Practice address
- 15300 West Ave
Orland Park, IL 60462-4600 - Phone
- (708) 403-8400
- Fax
- (708) 403-8492
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 036.056518 | IL | Primary |
Addresses
Primary practice location
15300 West Ave
Orland Park, IL 60462-4600
Mailing address
12251 S 80TH Ave
Suite 1630
Palos Heights, IL 60463-1256
Phone (708) 923-5173
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F400380350 | Other | IL | MEDICARE PTAN |
| 036056518 | Medicaid | IL |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101208001200 | IL | Practitioner - Endocrinology | 4789871302 |
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
15300 W Ave
Suite 122
Orland Park, IL 60462-4508
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.056518 | IL | MD | Endocrinology, Diabetes & Metabolism Physician |
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
- Psychiatric Hospital Unit
- Palos Heights, IL
- NPI 1184699118
-
- General Acute Care Hospital
- Palos Heights, IL
- NPI 1851386692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1508935222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12251 S 80TH AVE",
"address_2": "SUITE 1630",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631256",
"telephone_number": "708-923-5173",
"fax_number": "708-923-5018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15300 WEST AVE",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604624600",
"telephone_number": "708-403-8400",
"fax_number": "708-403-8492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAYARAM",
"first_name": "NITTOR",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "IL",
"license": "036.056518",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "F400380350",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036056518",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.