Individual provider Active NPI

Vijayalakshmi Thota, DO

  • Internal Medicine Physician
  • Orland Park, IL
National Provider Identifier
1972501039
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036088719 Issued in IL
Practice address
15300 West Avenue, Suite 223
Orland Park, IL 60462
Phone
(708) 923-7874
Fax
(708) 923-7876
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036088719 IL Primary

Addresses

Primary practice location

15300 West Avenue, Suite 223
Orland Park, IL 60462

Mailing address

12251 S. 80TH Avenue, Suite 1630
Palos Heights, IL 60463-1256
Phone (708) 923-7874

Other identifiers 1

IdentifierTypeStateIssuer
036088719MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000902 IL Practitioner - Internal Medicine 4880644988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Chicago College of Osteopathy, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

15300 W Ave BLDG a
Suite 100
Orland Park, IL 60462-4600
Phone (708) 226-2626

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

Hospital & facility affiliations

  • Palos Community Hospital Home Health Care Home health agency, Lemont, IL, CCN 147470
  • Palos Community Hospital Hospice Hospice, Lemont, IL, CCN 141591
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036088719ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Sep 1, 2021 Accepting new patients
Central Dupage Physician Group Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Vijayalakshmi Thota DO Internal Medicine PastSince Jan 1, 1990 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

15300 West Ave
Ste 303
Orland Park, IL 60462
Phone (708) 349-6713

15300 West Ave
Ste 223
Orland Park, IL 60462
Phone (708) 923-7874

15300 West Ave
Ste 222
Orland Park, IL 60462
Phone (708) 364-1050

15300 West Ave
Orland Park, IL 60462
Phone (708) 226-2440

15300 West Ave
Ste 30
Orland Park, IL 60462
Phone (708) 349-6700

12251 S 80th Ave
Ste 1630
Palos Heights, IL 60463
Phone (708) 923-5173

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 3

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 11

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1972501039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S. 80TH AVENUE, SUITE 1630",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-7874",
            "fax_number": "708-923-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 WEST AVENUE, SUITE 223",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60462",
            "telephone_number": "708-923-7874",
            "fax_number": "708-923-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOTA",
        "first_name": "VIJAYALAKSHMI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036088719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088719",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.