NPIMap

Individual provider Active NPI

Tara Shenoy, MD

  • Pediatrics Physician
  • Naperville, IL
National Provider Identifier
1952832834
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.152485 Issued in IL
Practice address
636 Raymond Dr Ste 205
Naperville, IL 60563-9791
Phone
(630) 717-2300
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 57.030199 OH
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 036.152485 IL Primary

Addresses

Primary practice location

636 Raymond Dr Ste 205
Naperville, IL 60563-9791

Mailing address

1707 Atwood Cir
Naperville, IL 60565-6746

Other practice location 1

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-4411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.152485ILMDPediatrics Physician
57.030199OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann & Robert H. Lurie Children'S Hospital of Chicago Current Accepting new patients
Pediatric Health Associates LTD Pediatrics Past Accepting new patients
University of Chicago Past Accepting new patients
Dupage Medical Group LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tshenoy45298@direct.luriechildrens.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1952832834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 ATWOOD CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605656746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR STE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639791",
            "telephone_number": "630-717-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-4411",
            "fax_number": "614-722-6132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENOY",
        "first_name": "TARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57.030199",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.152485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.