Individual provider Active NPI

Suresh Vrajlal Shingala, MD

  • Interventional Cardiology Physician
  • Chicago, IL
National Provider Identifier
1740386051
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
060-003510 Issued in IL
Practice address
5015 N Paulina St
#214
Chicago, IL 60640-2756
Phone
(773) 784-8500
Fax
(773) 989-5412
NPI assigned
Sep 15, 2006
Last updated
Aug 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 060-003510 IL Primary

Addresses

Primary practice location

5015 N Paulina St
#214
Chicago, IL 60640-2756

Mailing address

5015 N Paulina St
#214
Chicago, IL 60640-2756
Phone (773) 784-8500

Other identifiers 1

IdentifierTypeStateIssuer
036-054364MedicaidIL

Medicare participation

Medicare enrollment files
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
060-003510ILMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J Anesthesia and Pain Management LLC PastSince Nov 13, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1740386051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 N PAULINA ST",
            "address_2": "#214",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402756",
            "telephone_number": "773-784-8500",
            "fax_number": "773-989-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 N PAULINA ST",
            "address_2": "#214",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402756",
            "telephone_number": "773-784-8500",
            "fax_number": "773-989-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINGALA",
        "first_name": "SURESH",
        "middle_name": "VRAJLAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "060-003510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-054364",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.