NPIMap

Individual provider Active NPI

Chandana Vavilala, MD

  • Internal Medicine Physician
  • Saint John, IN
National Provider Identifier
1548230113
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01057596A Issued in IN
Practice address
10860 Maple LN
Saint John, IN 46373-8418
Phone
(219) 365-7000
Fax
(219) 365-2609
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01057596A IN Primary

Addresses

Primary practice location

10860 Maple LN
Saint John, IN 46373-8418

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other identifiers 2

IdentifierTypeStateIssuer
200496780MedicaidIN
00000072193OtherINANTHEM TRADITIONAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cvavilala4263@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050224000541 IN Practitioner - Internal Medicine 6406809904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

2050 N Main St
Suite F
Crown Point, IN 46307-2048
Phone (219) 663-3737

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network Internal Medicine Current Accepting new patients
Franciscan Physician Network CurrentSince Jan 1, 2012 Accepting new patients
Franciscan Physician Network CurrentSince Jan 1, 2012 Accepting new patients
Franciscan Health Crown Point Past Accepting new patients

Locations

35682 Eagle Way
Chicago, IL 60678

810 Michael Dr
#1
Chesterton, IN 46304
Phone (219) 395-2197

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

2050 N Main St
Ste F
Crown Point, IN 46307
Phone (219) 663-3737

1205 S Main St
Ste 201
Crown Point, IN 46307
Phone (219) 738-2279

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

10860 Maple Ln
Saint John, IN 46373
Phone (219) 365-7000

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: cvavilala4263@direct.franciscanalliance.org

Organizations & group practices 4

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 9

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1548230113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10860 MAPLE LN",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738418",
            "telephone_number": "219-365-7000",
            "fax_number": "219-365-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVILALA",
        "first_name": "CHANDANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01057596A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200496780",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM TRADITIONAL",
            "identifier": "00000072193",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cvavilala4263@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2050 N Main St",
            "address_2": "Suite F",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463072035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint John, IN

Sources for this page

Verify at the official NPI Registry.