Individual provider Active NPI

Mukul Bhattarai, MD.

  • Cardiovascular Disease Physician
  • Springfield, IL
National Provider Identifier
1013204262
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036-135174 Issued in IL
Practice address
747 N Rutledge St FL 4
Springfield, IL 62702-6700
Phone
(217) 545-8000
Fax
(217) 545-7877
NPI assigned
Jul 7, 2011
Last updated
May 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT198824 PA
Internal Medicine Physician 207R00000X 036-135174 IL
Cardiovascular Disease Physician 207RC0000X 036-135174 IL Primary

Addresses

Primary practice location

747 N Rutledge St FL 4
Springfield, IL 62702-6700

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000

Other practice location 1

751 N Rutledge St
Suite 1100
Springfield, IL 62702-4968
Phone (217) 545-8000

Other practice location 2

520 N 4th St
Springfield, IL 62702-5238
Phone (217) 545-0191

Other identifiers 1

IdentifierTypeStateIssuer
036135174MedicaidIL

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
I20140625001005 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9830314335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

520 N 4TH St
Springfield, IL 62702-5238
Phone (217) 545-8000

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT198824PAMDInternal Medicine Physician
036-135174ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 1, 2014 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Jun 1, 2022 Accepting new patients
Siu Physicians & Surgeons, Inc Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Jun 1, 2022 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients
Southern Illinois University Past Accepting new patients

Locations

201 E Madison St
Ste 328
Springfield, IL 62702

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

701 N 1st St
Rm B146
Springfield, IL 62781

747 N Rutledge St
#4
Springfield, IL 62702

747 N Rutledge St
Fl 4
Springfield, IL 62702

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

751 N Rutledge St
Ste 1100
Springfield, IL 62702
Phone (217) 545-0182

Networks

  • IL PPO Downstate
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1013204262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 328",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST FL 4",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 N Rutledge St",
            "address_2": "Suite 1100",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627024968",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025238",
            "country_code": "US",
            "telephone_number": "217-545-0191",
            "fax_number": "217-545-7063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHATTARAI",
        "first_name": "MUKUL",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT198824",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-135174",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-135174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036135174",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.