ESHWAR GUMIDYALA (MD) – Psychiatry Physician, NPI 1891794137

ESHWAR GUMIDYALA (MD) is a healthcare provider. based in Crystal lake, Illinois. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 036-094022 (IL). The NPI Number for ESHWAR GUMIDYALA (MD) is 1891794137

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
ESHWAR GUMIDYALA (MD)
NPI
1891794137
Phone
(815) 455-7100
Address
500 COVENTRY LN
Enumeration Date
19 July 2005
Last Update Date
5 July 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8154557100
Graduation Year
1986 (40 years ago)
PAC ID
3971546276
Group Practice PAC ID
4385531672
Professional Enrollment ID
I20101026000797
Address ID
IL600147555CR500XXLNXX303
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,367 PSYCHIATRY in IL

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Provider Addresses for ESHWAR GUMIDYALA (MD)

  • 500, Coventry Lane, Crystal Lake, McHenry County, Illinois, 60014, United States

    SUITE 205

    CRYSTAL LAKE, IL 600147579

    Phone: (815) 455-7100

    Fax: (815) 455-3951

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $198.

Total Amount is formed as General ($198) + Research ($0) + Ownership ($0) = $198.

Last reported payment date: 2024-03-15 • Largest payer in this snapshot: ABBVIE INC. ($122).

Total Amount

$198

General + Research + Ownership

Payments

9

Total payment records

General Amount

$198

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-10-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101026000797IPsychiatryILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes30491$0
View full utilization report →

Insurance plans in this area (ZIP 60014)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385531672View full group profile
NameSpecialtyState
Nurse PractitionerIL
Clinical PsychologistIL
Nurse PractitionerIL
P S Y C H I A T R YIL
Clinical Social WorkerIL
Clinical Social WorkerIL
-IL
P S Y C H I A T R YIL
Clinical PsychologistIL
-IL

Reviews

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Frequently asked questions

What unique ID ties claims to ESHWAR GUMIDYALA (MD)?
NPI 1891794137 is assigned to ESHWAR GUMIDYALA (MD) under the national enumeration system.
Is ESHWAR GUMIDYALA (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does ESHWAR GUMIDYALA (MD) list a primary specialty?
If you are matching referrals, note Psychiatry Physician for ESHWAR GUMIDYALA (MD). Clinical services aligned with this taxonomy classification.
What location shows for ESHWAR GUMIDYALA (MD)?
We surface Crystal Lake, Illinois for ESHWAR GUMIDYALA (MD) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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