NPIMap

Individual provider Active NPI

Rajendra Prasad Mullapudi, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1679764096
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036119143 Issued in IL
Practice address
1505 W Devon Ave
Chicago, IL 60660-1313
Phone
(872) 208-6457
Fax
(872) 208-6459
NPI assigned
Aug 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036119143 IL
Internal Medicine Physician 207R00000X 036119143 IL Primary

Addresses

Primary practice location

1505 W Devon Ave
Chicago, IL 60660-1313

Mailing address

3 Shenandoah CT
Burr Ridge, IL 60527-0319
Phone (630) 926-5409

Other identifiers 1

IdentifierTypeStateIssuer
036119143MedicaidIL

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
I20071005000745 IL Practitioner - Internal MedicinePractitioner - General PracticePractitioner - Family Practice 7113012030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians to You Home Health LimitedGroup PAC ID 5193972164, 10 clinicians

Practice addresses (Care Compare)

1505 W Devon Ave
Chicago, IL 60660-1313
Phone (872) 208-6457

6916 Cermak Rd
Berwyn, IL 60402-2244
Phone (708) 933-3840

Hospital & facility affiliations

  • Buena Vida Home Health Agency Inc. Home health agency, Chicago, IL, CCN 148403
  • Simply Home Health Healthcare Partners Medical LLC Home health agency, Chicago, IL, CCN 147958
  • Chicago Health, Inc Home health agency, Park Ridge, IL, CCN 147881
  • Innova Care Home health agency, Rosemont, IL, CCN 147733
  • Midwest Healthcare Provider, Inc Home health agency, Skokie, IL, CCN 148077
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Homecare Doctors LLC Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Mullapudi Medical LLC Internal Medicine CurrentSince Jun 27, 2011 Accepting new patients
Physicians to You Home Health Limited CurrentSince Mar 20, 2014 Accepting new patients
Dr Raj LTD PastSince May 1, 2008 Accepting new patients
Mullapudi Medical LLC Past Accepting new patients
San Pablo Medical Center, LTD. Internal Medicine Past Accepting new patients

Locations

6916 Cermak Rd
Berwyn, IL 60402
Phone (708) 933-3840

1505 W Devon Ave
Chicago, IL 60660
Phone (773) 316-5305

1480 Renaissance Dr
Ste 414
Park Ridge, IL 60068
Phone (847) 813-6216

Interoperability endpoints

  • Direct secure messaging: rmullapudi@phytou.curemd.direct-ci.com

Organizations & group practices 6

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1679764096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SHENANDOAH CT",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270319",
            "telephone_number": "630-926-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601313",
            "telephone_number": "872-208-6457",
            "fax_number": "872-208-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLAPUDI",
        "first_name": "RAJENDRA",
        "middle_name": "PRASAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036119143",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036119143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119143",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.