Individual provider Active NPI

Vin Mathur, MD

  • Neuroradiology Physician
  • Chicago, IL
National Provider Identifier
1871694810
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
036148391 Issued in IL
Practice address
5841 S. Maryland Ave
Mail Code 2026
Chicago, IL 60637-1443
Phone
(773) 834-9980
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X T2006029715 MO
Neuroradiology Physician 2085N0700X 036148391 IL Primary

Addresses

Primary practice location

5841 S. Maryland Ave
Mail Code 2026
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-4503
Phone (773) 702-1150

Other practice location 1

1402 S Grand Blvd Rm M260
Saint Louis, MO 63104-1004
Phone (314) 977-9853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200914002550 CA Practitioner - Diagnostic Radiology 2860708781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Columbia University College of Physicians and Surgeons, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1409 E Briggsmore Ave
Modesto, CA 95355-2707
Phone (209) 524-1211

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

2488 N California St
Stockton, CA 95204-5508
Phone (209) 948-3333

2505 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2545 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2800 L St
Sacramento, CA 95816-5616

441 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 830-4062

445 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 524-1211

447 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 830-4062

473 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 833-3320

599 E Valpico Rd
Tracy, CA 95376-9100
Phone (209) 830-4072

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

918 S Fairmont Ave
Lodi, CA 95240-5119
Phone (209) 366-2001

924 S Fairmont Ave
Lodi, CA 95240-5119
Phone (209) 334-2590

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Modesto, CA, CCN 050557
  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T2006029715MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Aug 24, 2020 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 24, 2020 Accepting new patients

Locations

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: vmathur553924@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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 2

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1871694810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605274503",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S. MARYLAND AVE",
            "address_2": "MAIL CODE 2026",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-834-9980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 S Grand Blvd Rm M260",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041004",
            "country_code": "US",
            "telephone_number": "314-977-9853",
            "fax_number": "314-977-1011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "VIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "T2006029715",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036148391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.