Viswanatham Susarla, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036047106 Issued in IL

Practice address

860 Summit St
Ste 123
Elgin, IL 60120-5145

Phone

(847) 741-0026

Fax

(847) 741-0027

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Geriatric MedicineAlso: Internal Medicine

Education

Other, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

V Susarla MDSCGroup PAC ID 2860400348, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: vsusarla287556@direct.myadvocateaurora.org

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.

• V Susarla MDSC

  • Internal Medicine Physician
  • Elgin, IL
  • NPI 1952583783
  Medicare reassignment Care Compare group Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Sherman Hospital

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1629026364
  Care Compare affiliation
• Sherman Hospital

  • Skilled Nursing Facility
  • Elgin, IL
  • NPI 1275584302

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1922014315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST",
            "address_2": "STE 123",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601205145",
            "telephone_number": "847-741-0026",
            "fax_number": "847-741-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST",
            "address_2": "STE 123",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601205145",
            "telephone_number": "847-741-0026",
            "fax_number": "847-741-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSARLA",
        "first_name": "VISWANATHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036047106",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036047106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0004500476",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047106",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "112910380",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vis.susarla@vsm.eclinicaldirect.com",
            "affiliation": "N",
            "address_1": "860 Summit St",
            "address_2": "Ste 123",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601205145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.healow.com/FHIRServer/fhir/FCGBAA",
            "affiliation": "N",
            "address_1": "860 Summit St",
            "address_2": "Ste 123",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601205145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Won Sung, DDS
• Mark Surma
• Arvind Surti, R.PH.
• Susan M Penner
• Savitha Susarla, D.O.
• Mirella Susnjar, M.D.
• Denisa Luminita Suteu
• Ezri Sutter, QMHP
• Hanna Marie Sutton, PA-C
• Sophia Sutton

• Internal Medicine Physician in Elgin, IL
• Providers in Elgin, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.