Individual provider Active NPI

Vinay Kumar Mikkilineni

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1710320189
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.140300 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Apr 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.140300 IL
Emergency Medicine Physician 207P00000X 036.140300 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

3102 Kings Rd
Unit #3309
Dallas, TX 75219-1316
Phone (979) 848-7169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181109000439 IL Practitioner - Internal Medicine 6002116357 Reassigns benefits to 1 organization
I20190717001351 MO Practitioner - Emergency Medicine 6002116357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians
Hannibal Regional Healthcare System IncGroup PAC ID 1254236300, 256 clinicians

Practice addresses (Care Compare)

840 S Wood St MC
787 Uic Medicine
Chicago, IL 60612-4325
Phone (312) 413-8687

PO Box
Suite 1257
Hannibal, MO 63401-1257
Phone (573) 248-5460

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150
  • Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.140300ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Sep 19, 2018 Accepting new patients
Hannibal Regional Healthcare System Inc CurrentSince Jun 8, 2019 Accepting new patients
Board of Trustees of the University of Illinois Emergency Medicine Current Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Sep 19, 2018 Accepting new patients

Locations

7732 Solution Ctr
Dept 3466
Chicago, IL 60677

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

840 S Wood St
#787
Chicago, IL 60612
Phone (312) 413-8687

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

6000 Hospital Dr
#1257
Hannibal, MO 63401
Phone (573) 248-5460

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: vmikkilineni17301@uihealth.direct-ci.com

Organizations & group practices 5

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 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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1710320189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 KINGS RD",
            "address_2": "UNIT #3309",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752191316",
            "telephone_number": "979-848-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKILINENI",
        "first_name": "VINAY",
        "middle_name": "KUMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.140300",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.140300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.