Organization Active NPI

Gatewaymd Live PLLC

  • Anesthesiology Physician
  • Glen Ellyn, IL
National Provider Identifier
1861214439
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GATEWAYMD LIVE PLLC
Practice address
731 Hillside Ave
Glen Ellyn, IL 60137-4616
Phone
(224) 607-7254
Fax
(224) 607-7254
NPI assigned
Oct 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Authorized official

Name
Rohan SundaralingamNPI 1548339559
Title
Owner
Phone
(224) 607-7254

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

731 Hillside Ave
Glen Ellyn, IL 60137-4616

Mailing address

731 Hillside Ave
Glen Ellyn, IL 60137-4616
Phone (224) 607-7254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, VA, TX, NM4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20241227002123 IL Part B Supplier - Clinic/Group Practice 3476080789 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Ellyn, IL
O20250521000453 VA Part B Supplier - Clinic/Group Practice 3476080789 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, VA
O20250529003363 TX Part B Supplier - Clinic/Group Practice 3476080789 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, TX; Sugar Land, TX
O20250716001156 NM Part B Supplier - Clinic/Group Practice 3476080789 Receives reassigned benefits from 1 practitioner
Practice locations: Las Cruces, NM

National Provider Directory

National Provider Directory

Locations

701 E Franklin St
Ste 1051740
Richmond, VA 23219
Phone (224) 607-7254

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1861214439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 HILLSIDE AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374616",
            "telephone_number": "224-607-7254",
            "fax_number": "224-607-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 HILLSIDE AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374616",
            "telephone_number": "224-607-7254",
            "fax_number": "224-607-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAYMD LIVE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "SUNDARALINGAM",
        "authorized_official_first_name": "ROHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-607-7254"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.