NPIMap

Individual provider Active NPI

Ruben Joseph Mylvaganam, M.D.

  • Pulmonary Disease Physician
  • Chicago, IL
National Provider Identifier
1629462676
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036146223 Issued in IL
Practice address
675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980
Phone
(312) 695-1800
Fax
(312) 908-4650
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036146223 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980

Mailing address

675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980
Phone (312) 695-1800

Other practice location 1

17 E 102nd St
7th Floor #1087
New York, NY 10029-5204
Phone (212) 659-8551

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
I20210611001458 IL Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3375887045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
New York University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone (708) 923-5869

675 N St Clair
250 Dept Endocrinology
Chicago, IL 60611-5975
Phone (312) 695-7970

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Jun 1, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Jun 1, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

675 N Saint Clair St
Ste 18-250
Chicago, IL 60611
Phone (312) 695-8624

676 N Saint Clair St
Ste 2100
Chicago, IL 60611
Phone (312) 695-3117

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1001 Commerce Dr
Ste 500
Oak Brook, IL 60523
Phone (331) 732-4490

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 4

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 7

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": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1629462676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115980",
            "telephone_number": "312-695-1800",
            "fax_number": "312-908-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115980",
            "telephone_number": "312-695-1800",
            "fax_number": "312-908-4650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 E 102nd St",
            "address_2": "7th Floor #1087",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100295204",
            "country_code": "US",
            "telephone_number": "212-659-8551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYLVAGANAM",
        "first_name": "RUBEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036146223",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.