Kavitha Gandhi, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

336-067198 Issued in IL

Practice address

351 S. Greenleaf
Suite E
Park City, IL 60085

Phone

(847) 680-7100

Fax

(847) 406-3345

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

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

Specialty

Dermatology

Education

Northwestern University Feinberg Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.25 of 100Reported as individual

Quality

95

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgandhi218943@direct.myadvocateaurora.org

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.

• Lake Shore Dermatology, LTD.

  • Dermatology Physician
  • Park City, IL
  • NPI 1902977937

  Dermatology, IL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639785600000",
    "number": "1629149653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 S. GREENLEAF",
            "address_2": "SUITE E",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-680-7100",
            "fax_number": "847-406-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 S. GREENLEAF",
            "address_2": "SUITE E",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-680-7100",
            "fax_number": "847-406-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "KAVITHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2021-12-18",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "336-067198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgandhi218943@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "351 S. Greenleaf",
            "address_2": "Suite E",
            "city": "Park City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kavitha.gandhi@lsd.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "351 S. Greenleaf",
            "address_2": "Suite E",
            "city": "Park City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "351 S. Greenleaf",
            "address_2": "Suite E",
            "city": "Park City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julia Jean Felix, PA-C
• Bonnie Finn
• Florian Chiropractic Center LLC
• Lynn M Florian, D.C.
• Asha Gandhi, M.D.S.C.
• Sanjay Gandhi, M.D.
• GL Pharmacy LLC
• Greenleaf Medical Associates S.C.
• Greenleaf Memory Clinic PLLC
• Greenleaf Orthodontics - Park City LLC

• All providers in Park City, IL
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2021; 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.

Verify at the official NPI Registry.