Individual provider Active NPI

Sreejith Mohan Velliyattikuzhi, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Springfield, IL
National Provider Identifier
1518308493
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
036148170 Issued in IL
Practice address
800 E Carpenter St
Springfield, IL 62769-4756
Phone
(217) 544-6464
NPI assigned
Jul 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT210326 PA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036148170 IL Primary

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62769-4756

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

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
I20190605000351 IL Practitioner - Critical Care (Intensivists) 2961790027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT210326PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Jul 1, 2019 Accepting new patients
HSHS Medical Group Inc CurrentSince Jul 1, 2019 Accepting new patients
HSHS Medical Group Inc Current Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643

800 E Carpenter St
Apt 305
Springfield, IL 62769

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.

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1518308493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627694756",
            "telephone_number": "217-544-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELLIYATTIKUZHI",
        "first_name": "SREEJITH",
        "middle_name": "MOHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT210326",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036148170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.