NPIMap

Individual provider Active NPI

Sushma Nagabhairava, MD

  • Family Medicine Physician
  • Lemont, IL
National Provider Identifier
1710265822
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-134615 Issued in IL
Practice address
15505 E 127TH St Ste 100
Lemont, IL 60439-4433
Phone
(630) 257-5400
NPI assigned
Jul 25, 2011
Last updated
Mar 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-134615 IL Primary

Addresses

Primary practice location

15505 E 127TH St Ste 100
Lemont, IL 60439-4433

Mailing address

15505 E 127TH St Ste 100
Lemont, IL 60439-4433
Phone (630) 257-5400

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
I20150724012340 IL Practitioner - Family Practice 1456591908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health Service Systems, IncGroup PAC ID 2264408699, 63 clinicians

Practice addresses (Care Compare)

15505 E 127TH St
Lemont, IL 60439-4433
Phone (630) 243-8888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-134615ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partnership of Illinois CurrentSince Jan 1, 2015 Accepting new patients
Health Service Systems, Inc CurrentSince Nov 1, 2017 Accepting new patients
Community Health Partnership of Illinois CurrentSince Jan 1, 2015 Accepting new patients
Health Service Systems, Inc Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Community Health Partnership of Illinois Current Accepting new patients
Anjali Kher, M.D., S.C. Past Accepting new patients

Locations

157 S Lincoln Ave
Ste D
Aurora, IL 60505
Phone (630) 859-0015

205 W Randolph St
Ste 2222
Chicago, IL 60606
Phone (312) 795-0000

15505 E 127th St
Lemont, IL 60439
Phone (630) 243-8888

15505 E 127th St
Ste 100
Lemont, IL 60439
Phone (630) 257-5400

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

13415 S Route 59
Plainfield, IL 60585
Phone (815) 274-6688

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1710265822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15505 E 127TH ST STE 100",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604394433",
            "telephone_number": "630-257-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15505 E 127TH ST STE 100",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604394433",
            "telephone_number": "630-257-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGABHAIRAVA",
        "first_name": "SUSHMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-134615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont, IL

Sources for this page

Verify at the official NPI Registry.