Individual provider Active NPI

Anusha Khapekar, D.O.

  • Pediatrics Physician
  • Joliet, IL
National Provider Identifier
1689028953
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
336.109955 Issued in IL
Practice address
1106 Neal Ave
Joliet, IL 60433-2548
Phone
(815) 727-8670
Fax
(815) 740-8149
NPI assigned
Apr 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1689028953 IL
Pediatrics Physician 208000000X 336.109955 IL Primary

Addresses

Primary practice location

1106 Neal Ave
Joliet, IL 60433-2548

Mailing address

806 Deer Trail LN
Oak Brook, IL 60523-7706
Phone (708) 582-3797

Other practice location 1

1675 Dempster St
Park Ridge, IL 60068-1110
Phone (847) 318-9300

Other names 1

  • Anusha Moolky Former name

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
I20191018001724 IL Practitioner - Pediatric Medicine 2264725126 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1689028953ILMDPediatrics Physician
336.109955ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Will County Community Health Center CurrentSince Sep 9, 2019 Accepting new patients
Will County Community Health Center CurrentSince Sep 9, 2019 Accepting new patients

Locations

1106 Neal Ave
Joliet, IL 60433
Phone (815) 727-5054

501 Ella Ave
Joliet, IL 60433
Phone (815) 727-8480

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: anusha.khapekar.p25@direct.willcounty.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1689028953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 DEER TRAIL LN",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605237706",
            "telephone_number": "708-582-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 NEAL AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604332548",
            "telephone_number": "815-727-8670",
            "fax_number": "815-740-8149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681110",
            "country_code": "US",
            "telephone_number": "847-318-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAPEKAR",
        "first_name": "ANUSHA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "1689028953",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "336.109955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANUSHA",
            "last_name": "MOOLKY",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.