NPIMap

Individual provider Active NPI

Premesh Malapati, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1730136763
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-114832 Issued in IL
Practice address
5600 W Addison St Lowr Level003
Chicago, IL 60634-4401
Phone
(708) 722-2572
Fax
(708) 722-1747
NPI assigned
May 27, 2006
Last updated
May 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-114832 IL Primary

Addresses

Primary practice location

5600 W Addison St Lowr Level003
Chicago, IL 60634-4401

Mailing address

824 Marengo Ave
Forest Park, IL 60130-2033
Phone (630) 748-9373

Other identifiers 1

IdentifierTypeStateIssuer
036114832MedicaidIL

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
I20060419000302 IL Practitioner - Emergency MedicinePractitioner - Internal Medicine 8921017963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5600 W Addison St
Ll003
Chicago, IL 60634-4444
Phone (708) 722-2572

5645 W Addison St
Chicago, IL 60634-4403
Phone (773) 282-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114832ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community First Healthcare of Illinois, Inc. CurrentSince May 2, 2017 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Malapati Inc Internal Medicine CurrentSince Jun 1, 2015 Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince May 2, 2017 Accepting new patients
Community First Healthcare of Illinois, Inc Past Accepting new patients

Locations

5600 W Addison St
Lowr 1LL
Chicago, IL 60634
Phone (773) 202-9622

5600 W Addison St
Lowr 3LL
Chicago, IL 60634
Phone (708) 722-2572

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

1 Erie Ct
Ste 3000
Oak Park, IL 60302
Phone (708) 383-7899

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIGECD
  • FHIR API: https://fhir4.healow.com/fhir/r4/DIGECD/Endpoint/DIGECD
  • Direct secure messaging: pmalapati96659@direct.luhs.org

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

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1730136763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 MARENGO AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302033",
            "telephone_number": "630-748-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W ADDISON ST LOWR LEVEL003",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344401",
            "telephone_number": "708-722-2572",
            "fax_number": "708-722-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAPATI",
        "first_name": "PREMESH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-114832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114832",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.