Individual provider Active NPI

Venkata Buddharaju, M.D., F.C.C.P.

  • Critical Care Medicine (Internal Medicine) Physician
  • Chicago, IL
National Provider Identifier
1790737781
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
036089871 Issued in IL
Practice address
840 W Irving Park Rd
305
Chicago, IL 60613
Phone
(773) 975-6775
Fax
(773) 975-1089
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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 036-089871 IL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036089871 IL Primary

Addresses

Primary practice location

840 W Irving Park Rd
305
Chicago, IL 60613

Mailing address

2180 De Cook Ave
Park Ridge, IL 60068-1538
Phone (773) 505-3071

Other identifiers 1

IdentifierTypeStateIssuer
01635515OtherILBCBS

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
I20031217000955 IL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 0446168520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Sleep Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2180 De Cook Ave
Park Ridge, IL 60068-1538

850 W Irving Park Rd
Thorek Memorial Hospital
Chicago, IL 60613-3077
Phone (773) 975-6775

Hospital & facility affiliations

  • Thorek Memorial Hospital Hospital, Chicago, IL, CCN 140115
  • Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Kindred Hospital - Chicago Long-term care hospital, Northlake, IL, CCN 142008

Merit-based Incentive Payment System (MIPS)

Final score
16.87 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
56.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-089871ILMDInternal Medicine Physician
036089871ILMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America Illinois Intensivists Critical Care Medicine Current Accepting new patients
Cep America Illinois Intensivists Critical Care Medicine CurrentSince Sep 15, 2018 Accepting new patients
Lakeview Pulmonary & Sleep Consultants LTD CurrentSince Mar 25, 2004 Accepting new patients
Cep America Illinois Intensivists Critical Care Medicine CurrentSince Sep 15, 2018 Accepting new patients
Thorek Radiology Group NFP Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2544 W Montrose Ave
Chicago, IL 60618
Phone (773) 267-2622

840 W Irving Park Rd
#305
Chicago, IL 60613
Phone (773) 447-0200

820 W Lawrence Ave
Chicago, IL 60640
Phone (773) 769-2570

4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102

3240 W Franklin Blvd
Chicago, IL 60624
Phone (773) 722-3020

550 W Webster Ave
Chicago, IL 60614
Phone (773) 883-1220

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

Organizations & group practices 5

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 6

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1790737781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 DE COOK AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681538",
            "telephone_number": "773-505-3071",
            "fax_number": "773-975-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD",
            "address_2": "305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "773-975-6775",
            "fax_number": "773-975-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDDHARAJU",
        "first_name": "VENKATA",
        "credential": "M.D., F.C.C.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-089871",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036089871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01635515",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.