Individual provider Active NPI

Pradnya P Vakil, P.A.

  • Physician Assistant
  • Champaign, IL
National Provider Identifier
1942472832
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003131 Issued in IL
Practice address
101 W University Ave
Champaign, IL 61820-3909
Phone
(217) 366-1255
Fax
(217) 366-6106
NPI assigned
Mar 31, 2008
Last updated
Jun 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-003131 IL Primary

Addresses

Primary practice location

101 W University Ave
Champaign, IL 61820-3909

Mailing address

101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1255

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080418000558 IL Practitioner - Physician Assistant 9032297841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians

Practice addresses (Care Compare)

101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1200

109 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-5180

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

1710 E Windsor Rd
Urbana, IL 61802-9564
Phone (217) 344-9440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-003131ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christie Clinic, PLLC CurrentSince Apr 1, 2007 Accepting new patients

Locations

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

1801 W Windsor Rd
Champaign, IL 61822
Phone (217) 366-5434

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

Interoperability endpoints

  • Direct secure messaging: lfeit@wih.cernerdirect.carene.org
  • Direct secure messaging: pvakilpa288489@carlehiedirect.net

Organizations & group practices 1

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1942472832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1255",
            "fax_number": "217-366-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1255",
            "fax_number": "217-366-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKIL",
        "first_name": "PRADNYA",
        "middle_name": "P",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.