Individual provider Active NPI

Asha N. Vijayakumar, MD

  • Internal Medicine Physician
  • Addison, IL
National Provider Identifier
1790724540
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-107591 Issued in IL
Practice address
303 W. Lake St
#200
Addison, IL 60101
Phone
(331) 221-9001
Fax
(847) 358-2770
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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 036-107591 IL Primary

Addresses

Primary practice location

303 W. Lake St
#200
Addison, IL 60101

Mailing address

172 Schiller
Elmhurst, IL 60126-2885
Phone (331) 221-9001

Other identifiers 1

IdentifierTypeStateIssuer
036-107591MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address avijayakumar205664@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2

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
I20050524000285 IL Practitioner - Internal Medicine 4789626417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

4847 Hoffman Blvd
Hoffman Estates, IL 60192-3722
Phone (847) 685-4646

Hospital & facility affiliations

  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-107591ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Mar 6, 2017 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 6, 2017 Accepting new patients
Concentra Primary Care of Illinois PC Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

6840 Main St
Ste 200
Downers Grove, IL 60516
Phone (630) 275-6840

Interoperability endpoints

  • Direct secure messaging: avijayakumar205664@direct.myadvocateaurora.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1790724540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 SCHILLER",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262885",
            "telephone_number": "331-221-9001",
            "fax_number": "331-221-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W. LAKE ST",
            "address_2": "#200",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "60101",
            "telephone_number": "331-221-9001",
            "fax_number": "847-358-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYAKUMAR",
        "first_name": "ASHA",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-107591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-107591",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avijayakumar205664@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8640 S Main Street",
            "address_2": "Suite 200",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "8640 S Main Street",
            "address_2": "Suite 200",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

Verify at the official NPI Registry.