Vinay Kumar Bhooma, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036150270 Issued in IL

Practice address

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284

Phone

(618) 233-5480

Fax

(618) 222-4790

NPI assigned

Jun 29, 2009

Last updated

Apr 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et1220.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: vinay.bhooma.1@9559.direct.athenahealth.com

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.

• Reid Health Ambulance, Inc.

  • Ambulance
  • Richmond, IN
  • NPI 1205308822
  NPD
• Reid Physician Associates, Inc

  dba Reid Health X-Ray Winchester

  • Radiology Clinic/Center
  • Winchester, IN
  • NPI 1417653221
  NPD (past)

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1730317702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 4000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691284",
            "telephone_number": "618-233-5480",
            "fax_number": "618-222-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 4000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691284",
            "telephone_number": "618-233-5480",
            "fax_number": "618-222-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHOOMA",
        "first_name": "VINAY",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01072949A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036150270",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01072949",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201188610",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vinay.bhooma.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3 Saint Elizabeth Blvd Ste 4000",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622691284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jameilyn Bell Best-Hanson
• Jennifer Lynn Bevirt-Mersinger
• Kevin Charles Beyersdorfer, DDS
• Shrinikethan Bharanidharan
• Harathi Bhooma, MD
• Casey Biancur, LCSW
• Gregory Biddulph, DMD
• Grace Olivia Biggers, RBT
• Sean Ryan Bird, DO
• Lindsey Renae Bischoff

• Family Medicine Physician in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.