NPIMap

Individual provider Active NPI

Sanjay Gandhi, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Park City, IL
National Provider Identifier
1821149238
Registry record updated Dec 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
036-101308 Issued in IL
Practice address
351 Greenleaf Ave Ste E
Park City, IL 60085-5701
Phone
(847) 234-1100
Fax
(847) 775-0703
NPI assigned
Jan 13, 2007
Last updated
Dec 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 036101308 IL
Urology Physician 208800000X 036101308 IL
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 036-101308 IL Primary

Addresses

Primary practice location

351 Greenleaf Ave Ste E
Park City, IL 60085-5701

Mailing address

351 Greenleaf Ave Ste E
Park City, IL 60085-5701
Phone (847) 234-1100

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sgandhi235674@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ Direct
Direct Messaging Address sanjay.gandhi@nsu.eclinicaldirect.com Direct

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
I20041019000862 IL Practitioner - Urology 4587625017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Northwestern University Feinberg Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Urogynecology LTDGroup PAC ID 9638124571, 2 clinicians

Practice addresses (Care Compare)

351 Greenleaf St
Park City, IL 60085-5701
Phone (847) 234-1100

351 Greenleaf St E
Park City, IL 60085-5701

3703 Doty Rd
Unit 2
Woodstock, IL 60098-7517
Phone (847) 234-1100

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (847) 234-1100

660 N Westmoreland
Lake Forest HSP
Lake Forest, IL 60045-1659
Phone (847) 234-1100

660 N Westmoreland Rd
Suite 306
Lake Forest, IL 60045-1659
Phone (847) 234-1100

7435 W Talcott Ave
Chicago, IL 60631-3707
Phone (844) 327-1188

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-101308ILMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician
036101308ILMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omnidoc Health Inc Urogynecology and Reconstructive Pelvic Surgery Current Accepting new patients
Advocate Condell Medical Center Past Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Asha Gandhi M.D.S.C PastSince Sep 1, 2005 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
James E Jupa MD SC Past Accepting new patients

Locations

351 Greenleaf St
Ste E
Park City, IL 60085
Phone (847) 680-7100

Organizations & group practices 7

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 8

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": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639785600000",
    "number": "1821149238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 GREENLEAF AVE STE E",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "600855701",
            "telephone_number": "847-234-1100",
            "fax_number": "847-775-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 GREENLEAF AVE STE E",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "600855701",
            "telephone_number": "847-234-1100",
            "fax_number": "847-775-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "SANJAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2021-12-18",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036101308",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036101308",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "IL",
            "license": "036-101308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgandhi235674@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "351 Greenleaf Ave Ste E",
            "city": "Park City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600855701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "351 Greenleaf Ave Ste E",
            "city": "Park City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600855701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sanjay.gandhi@nsu.eclinicaldirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "351 Greenleaf Ave Ste E",
            "city": "Park City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600855701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park City, IL

Sources for this page

Verify at the official NPI Registry.