Individual provider Active NPI

John P Vaikutis, DO

  • Family Medicine Physician
  • Aurora, IL
National Provider Identifier
1528098365
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036084166 Issued in IL
Practice address
2800 Beverly Dr
Aurora, IL 60502-8516
Phone
(630) 315-8700
Fax
(630) 315-8777
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036084166 IL Primary

Addresses

Primary practice location

2800 Beverly Dr
Aurora, IL 60502-8516

Mailing address

2800 Beverly Dr
Aurora, IL 60502-8516
Phone (630) 315-8700

Other identifiers 5

IdentifierTypeStateIssuer
3631498336019001OtherILCDPG HFS PAYEE ID
482450OtherILMEDICARE GROUP NUMBER
0222075OtherILBLUE CROSS GROUP NUMBER
036084166MedicaidIL
363149833OtherILTAX IDENTIFICATION NUMBER

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
I20101214001189 IL Practitioner - Family Practice 9931396033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

636 Raymond Dr
Naperville, IL 60563-9789
Phone (630) 315-6500

Hospital & facility affiliations

  • Resilience Home Health, LLC Home health agency, Aurora, IL, CCN 147998
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Marianjoy Rehabilitation Center Inpatient rehabilitation facility, Wheaton, IL, CCN 143027

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036084166ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince Feb 1, 1999 Accepting new patients
Central Dupage Physician Group CurrentSince Feb 1, 1999 Accepting new patients
Roy J. Betti, M.D.S.C. Past Accepting new patients

Locations

2635 Church Rd
Ste 201
Aurora, IL 60502
Phone (630) 315-8700

2800 Beverly Dr
Aurora, IL 60502
Phone (630) 315-8700

820 S State Route 59
Bartlett, IL 60103
Phone (630) 213-9600

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

636 Raymond Dr
Ste 200
Naperville, IL 60563
Phone (630) 355-5302

636 Raymond Dr
Naperville, IL 60563
Phone (630) 355-5302

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

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.

Hospital & facility affiliations 7

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1528098365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 BEVERLY DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605028516",
            "telephone_number": "630-315-8700",
            "fax_number": "630-315-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BEVERLY DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605028516",
            "telephone_number": "630-315-8700",
            "fax_number": "630-315-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIKUTIS",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036084166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPG HFS PAYEE ID",
            "identifier": "3631498336019001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "482450",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "0222075",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084166",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "363149833",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.