Active NPI
Arvind Reddy Devanabanda
- Cardiovascular Disease Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036158345
- Practice address
- 900 Main St Ste 660
Peoria, IL 61602-1060 - Phone
- (309) 672-4760
- NPI assigned
- May 19, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | A171266 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Cardiovascular Disease Physician | 207RC0000X | 036158345 | IL | Primary |
Addresses
Primary practice location
900 Main St Ste 660
Peoria, IL 61602-1060
Mailing address
611 W Park St
Fapc
Urbana, IL 61801-2500
Other practice location 1
550 First Avenue
New York, NY 10016-9998
Phone (212) 263-6397
Other practice location 2
127 S San Vicente Blvd Ste A3600
Los Angeles, CA 90048-3311
Phone (310) 423-3977
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Boston University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670
1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 263-4343
201 N Cummings LN
Washington, IL 61571-2181
Phone (309) 444-3627
205 N Cummings LN
Suite B
Washington, IL 61571-2181
Phone (309) 691-6610
209 N Cummings LN
Washington, IL 61571-2181
Phone (309) 643-6185
221 NE Glen Oak Ave
Peoria, IL 61636-0001
5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000
600 S 13TH St
Pekin, IL 61554-4936
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
900 Main St
Peoria, IL 61602-1060
Hospital & facility affiliations
- Carle Health Methodist Hospital
- Carle Health Proctor Hospital
- Carle Health Pekin Hospital
- Saint Francis Medical Center
- Carle Eureka Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 94 |
| Pacemaker insertion or repair | 1-10 |
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 281131 | NY | MD | Community Health Worker |
| 036158345 | IL | MD | Cardiovascular Disease Physician |
| A171266 | CA | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proctor Health Systems | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Interventional Cardiology | Current | Accepting new patients |
| Proctor Health Systems | Current | Accepting new patients | |
| Carle Health Care Incorporated | Cardiovascular Disease | Current | Accepting new patients |
| Carle Health Care Incorporated | Past | Accepting new patients |
Locations
1506 W Garfield Ave
Bartonville, IL 61607
Phone (309) 697-2416
600 S 13th St
Ste D
Pekin, IL 61554
Phone (309) 347-2700
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000
2338 W Van Winkle Way
Ste 1100
Peoria, IL 61615
815 Main St
Ste A1
Peoria, IL 61602
5401 N Knoxville Ave
Ste 217
Peoria, IL 61614
Phone (309) 282-1864
900 Main St
Ste 660
Peoria, IL 61602
Phone (309) 272-7724
5401 N Knoxville Ave
Ste 207
Peoria, IL 61614
Phone (309) 672-4640
5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610
112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402
530 Park Ave E
Ste 409
Princeton, IL 61356
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- adevanabandamd388527@carlehiedirect.net
Organizations & group practices 7
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.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Cardiovascular Disease
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1982656575
-
- Family Medicine Physician
- Peoria, IL
- NPI 1134173917
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
dba Methodist Medical Group
- Family Medicine Physician
- Peoria, IL
- NPI 1184670663
Interventional Cardiology
-
dba Carle Health Princeville
- Rural Health Clinic/Center
- Princeville, IL
- NPI 1356057301
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1114240876
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Advocate Eureka Hospital
- Critical Access Hospital
- Eureka, IL
- NPI 1184644023
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
dba Proctor Hospital
- General Acute Care Hospital
- Peoria, IL
- NPI 1033116876
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1134826894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1578974069",
"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": "618012500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MAIN ST STE 660",
"city": "PEORIA",
"state": "IL",
"postal_code": "616021060",
"telephone_number": "309-672-4760"
}
],
"practiceLocations": [
{
"address_1": "550 First Avenue",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100169998",
"country_code": "US",
"telephone_number": "212-263-6397",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "127 S San Vicente Blvd Ste A3600",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900483311",
"country_code": "US",
"telephone_number": "310-423-3977",
"fax_number": "310-423-6795",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEVANABANDA",
"first_name": "ARVIND REDDY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-19",
"last_updated": "2025-02-18",
"certification_date": "2025-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "CA",
"license": "A171266",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036158345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.