NPIMap

Individual provider Active NPI

Nirav P Chudgar, MD

  • Internal Medicine Physician
  • Calumet City, IL
National Provider Identifier
1780763805
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036096495 Issued in IL
Practice address
1600 167TH St Ste 200
Calumet City, IL 60409-5445
Phone
(708) 832-0244
Fax
(708) 832-1008
NPI assigned
Nov 2, 2006
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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 01047212A IN
Internal Medicine Physician 207R00000X 036096495 IL Primary

Addresses

Primary practice location

1600 167TH St Ste 200
Calumet City, IL 60409-5445

Mailing address

1600 167TH St Ste 200
Calumet City, IL 60409-5445
Phone (708) 832-0244

Other identifiers 1

IdentifierTypeStateIssuer
036096495MedicaidIL

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
I20070201000280 IL Practitioner - Internal Medicine 3577565738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1600 167TH St
Calumet City, IL 60409-5445
Phone (708) 832-0244

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036096495ILMDInternal Medicine Physician
01047212AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nirav P Chudgar MDSC Internal Medicine CurrentSince Feb 1, 2007 Accepting new patients

Locations

1600 167th St
Ste 200
Calumet City, IL 60409
Phone (708) 283-2600

1600 Torrence Ave
Calumet City, IL 60409
Phone (708) 730-1300

Interoperability endpoints

  • Direct secure messaging: nchudgarmd237107@uchospital.direct-ci.com
  • Direct secure messaging: nirav.chudgar@directaddress.net

Organizations & group practices 1

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 7

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1780763805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 167TH ST STE 200",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095445",
            "telephone_number": "708-832-0244",
            "fax_number": "708-832-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 167TH ST STE 200",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095445",
            "telephone_number": "708-832-0244",
            "fax_number": "708-832-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUDGAR",
        "first_name": "NIRAV",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01047212A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036096495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096495",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

Verify at the official NPI Registry.