Individual provider Active NPI

Prafull C Gandhi, MD

  • Internal Medicine Physician
  • Schaumburg, IL
National Provider Identifier
1841391042
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-077669 Issued in IL
Practice address
1301 N Plum Grove Rd
Schaumburg, IL 60173-4547
Phone
(847) 490-0600
NPI assigned
Sep 26, 2006
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C187070 CA
Internal Medicine Physician 207R00000X 036-077669 IL Primary

Addresses

Primary practice location

1301 N Plum Grove Rd
Schaumburg, IL 60173-4547

Mailing address

1530 Center St
Des Plaines, IL 60018-1723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX, CA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20090210000452 IL Practitioner - Internal MedicinePractitioner - Hospitalist 6507921459 Reassigns benefits to 2 organizations
I20130814000328 TX Practitioner - Internal Medicine 6507921459 Reassigns benefits to 1 organization
I20241206001939 CA Practitioner - Family PracticePractitioner - Internal Medicine 6507921459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity Healthcare Services PCGroup PAC ID 2668812710, 27 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C187070CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
24 On Physicians, PC CurrentSince Aug 22, 2015 Accepting new patients
Mercy Health System Corporation CurrentSince Jul 27, 2019 Accepting new patients
Mercy Health System Corporation CurrentSince Jul 27, 2019 Accepting new patients
Vituity Healthcare Services PC Family Medicine CurrentSince Nov 1, 2024 Accepting new patients
24 On Physicians, P.C. CurrentSince Aug 22, 2015 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

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

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

901 Grant St
Harvard, IL 60033
Phone (815) 943-2961

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1841391042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 CENTER ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600181723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N PLUM GROVE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734547",
            "telephone_number": "847-490-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "PRAFULL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C187070",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-077669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.