Individual provider Active NPI

Karthik Shastri, M.D.

  • Otolaryngology Physician
  • Glenview, IL
National Provider Identifier
1619362795
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036157688 Issued in IL
Practice address
2701 Patriot Blvd
Glenview, IL 60026-8039
Phone
(847) 724-4536
Fax
(847) 509-0536
NPI assigned
Apr 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 60856 TN
Facial Plastic Surgery Physician 207YS0123X 60856 NY
Student in an Organized Health Care Education/Training Program 390200000X 63652 NY
Otolaryngology Physician 207Y00000X 036157688 IL Primary

Addresses

Primary practice location

2701 Patriot Blvd
Glenview, IL 60026-8039

Mailing address

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 724-4536

Other practice location 1

3601 The Vanderbilt Clinic
Nashville, TN 37232
Phone (615) 322-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kshastri575434@direct.vumc.org Direct

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
I20211006002747 IL Practitioner - Otolaryngology 7810234093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Drexel University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 724-4536

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision69
Removal of skin lesions1-10
Skin biopsy36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036157688ILMDOtolaryngology Physician
60856TNMDOtolaryngology Physician
60856NYMDFacial Plastic Surgery Physician
63652NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

2701 Patriot Blvd
Glenview, IL 60026
Phone (847) 724-4536

800 N Westmoreland Rd
Ste 102
Lake Forest, IL 60045
Phone (847) 295-1300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

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 2

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": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1619362795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268039",
            "telephone_number": "847-724-4536",
            "fax_number": "847-509-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268039",
            "telephone_number": "847-724-4536",
            "fax_number": "847-509-0536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "37232",
            "country_code": "US",
            "telephone_number": "615-322-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHASTRI",
        "first_name": "KARTHIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-05",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "60856",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NY",
            "license": "60856",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "63652",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036157688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshastri575434@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.