Individual provider Active NPI

Bhanu K Vakkalanka, M.D.

  • Medical Oncology Physician
  • Normal, IL
National Provider Identifier
1578766796
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
036125938 Issued in IL
Practice address
407 E Vernon Ave
Normal, IL 61761-3813
Phone
(309) 451-8500
Fax
(309) 451-2299
NPI assigned
Jun 6, 2007
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57010826 OH
Medical Oncology Physician 207RX0202X 60946 MN
Medical Oncology Physician 207RX0202X 036125938 IL Primary

Addresses

Primary practice location

407 E Vernon Ave
Normal, IL 61761-3813

Mailing address

611 W. Park St
Fapc
Urbana, IL 61801

Other practice location 1

500 John Deere Rd Ste 102
Moline, IL 61265-6892
Phone (309) 779-4940 ext. 4983

Other practice location 2

1400 Pin Oak Dr
Carterville, IL 62918-1600
Phone (618) 985-3333

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bvakkalanka323480@excellian.direct.allina.com Direct
Direct Messaging Address bvakkalanka72352@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101012001232 IL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3072705789 Reassigns benefits to 4 organizations
I20221201000141 IA Practitioner - Medical Oncology 3072705789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trinity Medical CenterGroup PAC ID 2264337518, shared by 4 NPIs, 97 clinicians

Practice addresses (Care Compare)

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-5000

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-3180

500 John Deere Rd
Moline, IL 61265-6892
Phone (309) 779-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57010826OHMDInternal Medicine Physician
60946MNMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Center Current Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Carle Eureka Hospital Current Accepting new patients
Mercy Specialty Clinic CurrentSince Jun 26, 2023 Accepting new patients
Mercy Specialty Clinic CurrentSince Jun 26, 2023 Accepting new patients
Carle West Physician Group Inc CurrentSince Feb 20, 2023 Accepting new patients
Trinity Medical Center Internal Medicine CurrentSince Sep 16, 2019 Accepting new patients
Southern Illinois Medical Services, NFP Internal Medicine CurrentSince Oct 2, 2023 Accepting new patients
Medical Associates of Clinton, Iowa P.L.C. Internal Medicine Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Sujatha Rao M.D., P.C. Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

915 13th Ave N
Clinton, IA 52732
Phone (319) 243-2511

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

1390 Hope Dr
Carbondale, IL 62901
Phone (618) 351-4972

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

1400 Pin Oak Dr
Carterville, IL 62918
Phone (618) 529-3159

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

500 John Deere Rd
Moline, IL 61265
Phone (309) 779-2840

500 John Deere Rd
Ste 102
Moline, IL 61265
Phone 3097794940 ext. 4983

407 E Vernon Ave
Normal, IL 61761
Phone (309) 451-2231

407 E Vernon Ave
Ste 104
Normal, IL 61761
Phone (309) 287-7539

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: bvakkalanka1050864@direct.unitypoint.org
  • Direct secure messaging: bvakkalanka323480@excellian.direct.allina.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1578766796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E VERNON AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613813",
            "telephone_number": "309-451-8500",
            "fax_number": "309-451-2299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 John Deere Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Moline",
            "state": "IL",
            "postal_code": "612656892",
            "country_code": "US",
            "telephone_number": "309-779-4940 x4983",
            "fax_number": "309-779-4989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Pin Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Carterville",
            "state": "IL",
            "postal_code": "629181600",
            "country_code": "US",
            "telephone_number": "618-985-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAKKALANKA",
        "first_name": "BHANU",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57010826",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MN",
            "license": "60946",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036125938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bvakkalanka323480@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1285 Nininger Rd",
            "city": "Hastings",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550331086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bvakkalanka72352@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "1400 Pin Oak Dr",
            "city": "Carterville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629181600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.