Individual provider Active NPI

Jobby Mampilly, M.D.

  • Pulmonary Disease Physician
  • Naperville, IL
National Provider Identifier
1639340029
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036120190 Issued in IL
Practice address
100 Spalding Dr Ste 102
Naperville, IL 60540-6551
Phone
(630) 871-6699
NPI assigned
Mar 13, 2008
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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 036.120190 IL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036120190 IL
Pulmonary Disease Physician 207RP1001X 036120190 IL Primary

Addresses

Primary practice location

100 Spalding Dr Ste 102
Naperville, IL 60540-6551

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jobby.mampilly@dulyhealthandcare.direct-ci.com

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
I20080703000434 IL Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 1456423672 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Northwestern University Feinberg Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

100 Spalding Dr
Suite 102
Naperville, IL 60540-6551
Phone (630) 871-6699

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.120190ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Hospital CurrentSince Jan 1, 2014 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 13, 2023 Accepting new patients
Edward Health Ventures Internal Medicine CurrentSince Aug 19, 2023 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Dec 13, 2023 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 16, 2012 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 16, 2012 Accepting new patients
Edward Hospital CurrentSince Jan 1, 2014 Accepting new patients
Edward Health Ventures CurrentSince Aug 19, 2023 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

5601 S County Line Rd
Hinsdale, IL 60521
Phone (630) 286-4000

330 Madison St
Ste 103
Joliet, IL 60435
Phone (815) 741-2900

100 Spalding Dr
Ste 102
Naperville, IL 60540
Phone (630) 355-5860

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

Interoperability endpoints

  • FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/
  • Direct secure messaging: jmampilly15220@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: jobby.mampilly@dulyhealthandcare.direct-ci.com

Organizations & group practices 8

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 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": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1639340029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPALDING DR STE 102",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406551",
            "telephone_number": "630-871-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMPILLY",
        "first_name": "JOBBY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-13",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.120190",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036120190",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036120190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jobby.mampilly@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "100 Spalding Dr Ste 102",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605406551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.