Individual provider Active NPI

Antony Edukutharayil, DPM

  • Podiatrist
  • Merrillville, IN
National Provider Identifier
1649344979
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07001091A Issued in IN
Practice address
8300 Broadway
Suite D1
Merrillville, IN 46410-8602
Phone
(219) 750-9497
Fax
(219) 359-3181
NPI assigned
Nov 20, 2006
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 07001091A IN Primary

Addresses

Primary practice location

8300 Broadway
Suite D1
Merrillville, IN 46410-8602

Mailing address

314 Wilkins Dr
Des Plaines, IL 60016-2465
Phone (651) 707-7046

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070111000113 IL Practitioner - Podiatry 3779512363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Extremity Medical Care, IncGroup PAC ID 8224492988, 2 clinicians

Practice addresses (Care Compare)

11801 Southest Hwy
Suite 4N
Palos Heights, IL 60463-1145
Phone (708) 448-9300

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue298
Removal of nail tissue1070
Removal or shaving of skin growth207
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07001091AINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Extremity Medical Care, Inc Podiatrist CurrentSince May 30, 2025 Accepting new patients
Ebenezer Home Care Past Accepting new patients
Housecall Doctors. P.C. PastSince May 1, 2015 Accepting new patients
Housecall Doctors PC Podiatrist Past Accepting new patients
M & F Medical Services, LTD PastSince Sep 23, 2011 Accepting new patients
Allina Health System Past Accepting new patients
Lake Mi Mobile Doctors P.C. Podiatrist Past Accepting new patients

Locations

11801 Southwest Hwy
Ste 3N
Palos Heights, IL 60463
Phone (708) 448-9300

11801 Southwest Hwy
Ste 4N
Palos Heights, IL 60463
Phone (708) 448-9300

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1649344979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 WILKINS DR",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162465",
            "telephone_number": "651-707-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 BROADWAY",
            "address_2": "SUITE D1",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108602",
            "telephone_number": "219-750-9497",
            "fax_number": "219-359-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDUKUTHARAYIL",
        "first_name": "ANTONY",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001091A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.