Individual provider Active NPI

Maya Vallabhaneni Defoe, M.D.

  • Hospitalist Physician
  • Chicago, IL
National Provider Identifier
1811253255
Registry record updated Dec 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036.137189 Issued in IL
Practice address
251 E Huron St
Feinberg 16-738
Chicago, IL 60611-2908
Phone
(312) 926-5924
Fax
(312) 926-6134
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036.137189 IL Primary

Addresses

Primary practice location

251 E Huron St
Feinberg 16-738
Chicago, IL 60611-2908

Mailing address

251 E Huron St
Feinberg 16-738
Chicago, IL 60611-2908
Phone (312) 926-5924

Other names 1

  • Maya Vallabhaneni Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150817001173 IL Practitioner - HospitalistPractitioner - Internal Medicine 5496060733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Georgetown University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

680 N Lake Shore Dr
Suite 810
Chicago, IL 60611-8700
Phone (312) 926-6146

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.137189ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2015 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2015 Accepting new patients
Central Dupage Physician Group Hospitalist Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

251 E Huron St
#16738
Chicago, IL 60611
Phone (312) 926-5924

251 E Huron St
#16
Chicago, IL 60611

680 N Lake Shore Dr
Ste 810
Chicago, IL 60611
Phone (312) 926-8811

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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 1

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449878400000",
    "number": "1811253255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "address_2": "FEINBERG 16-738",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-5924",
            "fax_number": "312-926-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "address_2": "FEINBERG 16-738",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-5924",
            "fax_number": "312-926-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFOE",
        "first_name": "MAYA",
        "middle_name": "VALLABHANENI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2015-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.137189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYA",
            "last_name": "VALLABHANENI",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.