NPIMap

Individual provider Active NPI

Adai V Karuthalackal, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1558848671
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1901 W Harrison St
Chicago, IL 60612-3714
Phone
(312) 864-2246
NPI assigned
Jul 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 864-2246

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adai.karuthalackal@direct.ccprovider.org Direct Cook County

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
I20180919002791 IL Practitioner - Physician Assistant 0143571869 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

2101 Waukegan Rd
Bannockburn, IL 60015-1836

4700 Gilbert Ave
Suite 51
Western Springs, IL 60558-1664
Phone (708) 387-1750

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

550 W Ogden Ave
Hinsdale, IL 60521-3186
Phone (630) 323-6116

Hospital & facility affiliations

  • John H Stroger Jr Hospital Hospital, Chicago, IL, CCN 140124

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC CurrentSince Jun 14, 2024 Accepting new patients
Cook County CurrentSince Apr 18, 2019 Accepting new patients
Cook County CurrentSince Apr 18, 2019 Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Jun 12, 2024 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Jun 14, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Aug 22, 2018 Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

9532 Eagle Way
Chicago, IL 60678

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

1034 Warren Ave
Downers Grove, IL 60515
Phone (630) 852-7325

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

550 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 323-6116

951 Essington Rd
Joliet, IL 60435
Phone (815) 744-4551

4700 Gilbert Ave
Ste 51
Western Springs, IL 60558
Phone (708) 387-1737

1010 Executive Dr
Ste 250
Westmont, IL 60559
Phone (630) 655-8785

Organizations & group practices 10

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 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1558848671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARUTHALACKAL",
        "first_name": "ADAI",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-21",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adai.karuthalackal@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.