Individual provider Active NPI

Soumya Jayasankar, M.D.

  • Emergency Medicine Physician
  • Winfield, IL
National Provider Identifier
1730491622
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036131683 Issued in IL
Practice address
25 N Winfield Rd
Winfield, IL 60190-1222
Phone
(630) 933-1600
NPI assigned
Jul 8, 2010
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036131683 IL Primary

Addresses

Primary practice location

25 N Winfield Rd
Winfield, IL 60190-1222

Mailing address

25 N Winfield Rd
Winfield, IL 60190-1222
Phone (630) 933-1600

Other practice location 1

17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 799-8000

Other names 1

  • Soumya Venkiteswaran 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
I20131021000533 IL Practitioner - Emergency Medicine 3375778707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Emergency Physicians PCGroup PAC ID 5597763706, 37 clinicians

Practice addresses (Care Compare)

25 N Winfield Rd
Winfield, IL 60190-1222
Phone (630) 933-1600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Mar 1, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 1, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 4

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 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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1730491622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901222",
            "telephone_number": "630-933-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901222",
            "telephone_number": "630-933-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17800 Kedzie Ave",
            "address_purpose": "LOCATION",
            "city": "Hazel Crest",
            "state": "IL",
            "postal_code": "604292029",
            "country_code": "US",
            "telephone_number": "708-799-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAYASANKAR",
        "first_name": "SOUMYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036131683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOUMYA",
            "last_name": "VENKITESWARAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.