Individual provider Active NPI

Surendar Dwarakanathan, MD

  • Ophthalmology Physician
  • Schererville, IN
National Provider Identifier
1801865332
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036-111537 Issued in IL
Practice address
320 W US Highway 30
Schererville, IN 46375-1856
Phone
(708) 860-5432
Fax
(773) 245-5244
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X M1649 TX
Ophthalmology Physician 207W00000X 036-111537 IL Primary

Addresses

Primary practice location

320 W US Highway 30
Schererville, IN 46375-1856

Mailing address

1750 W Division St Apt 401
Chicago, IL 60622-8815
Phone (708) 860-5432

Other identifiers 1

IdentifierTypeStateIssuer
177348302MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sdwarakan@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060720000274 IL Practitioner - Ophthalmology 7911937982 Reassigns benefits to 1 organization
I20160301001830 IN Practitioner - Ophthalmology 7911937982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Albany Medical College of Union University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians
Helix Eye Care PCGroup PAC ID 7214232131, 5 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

326 W US Hwy 30
Schererville, IN 46375-1856
Phone (219) 335-2400

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

Hospital & facility affiliations

  • John H Stroger Jr Hospital Hospital, Chicago, IL, CCN 140124
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008
  • Methodist Hospitals Inc Hospital, Gary, IN, CCN 150002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery488

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-111537ILMDOphthalmology Physician
M1649TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Associates LTD Ophthalmology CurrentSince Apr 1, 2020 Accepting new patients
Cook County CurrentSince Nov 1, 2010 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Nov 1, 2010 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

326 W US Highway 30
Schererville, IN 46375
Phone (219) 335-2400

Interoperability endpoints

  • Direct secure messaging: sd@helixeyecare.direct.eyemdemr.com

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 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1801865332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 W DIVISION ST APT 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228815",
            "telephone_number": "708-860-5432",
            "fax_number": "773-245-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W US HIGHWAY 30",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751856",
            "telephone_number": "708-860-5432",
            "fax_number": "773-245-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWARAKANATHAN",
        "first_name": "SURENDAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "M1649",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-111537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177348302",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdwarakan@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

Verify at the official NPI Registry.