NPIMap

Individual provider Active NPI

Sanjay A Thakkar, M.D.

  • Internal Medicine Physician
  • Yorkville, IL
National Provider Identifier
1073548483
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036107028 Issued in IL
Practice address
88 West Countryside Parkway
Yorkville, IL 60560
Phone
(630) 882-6441
Fax
(630) 882-6443
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 036107028 IL Primary

Addresses

Primary practice location

88 West Countryside Parkway
Yorkville, IL 60560

Mailing address

741 Lindsey LN
Bolingbrook, IL 60440-6171
Phone (630) 679-0651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906000929 IL Practitioner - Internal Medicine 5890727317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yorkville Internists SCGroup PAC ID 5496759011, 2 clinicians

Practice addresses (Care Compare)

2720 E New York St
Suite 108
Aurora, IL 60502-9507
Phone (630) 820-7045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
48.34 of 100Reported as individual
Quality
50.5
Improvement activities
0
Cost
65.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036107028ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Home Health Services LLC Current Accepting new patients
Yorkville Internists, S.C. Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients
Divine Hospice & Palliative Care LLC Internal Medicine Current Accepting new patients

Locations

2720 E New York St
Ste 108
Aurora, IL 60502
Phone (630) 820-7045

88 W Countryside Pkwy
Ste D
Yorkville, IL 60560
Phone (630) 352-3700

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
DMJ Home Health Services IncAurora, IL, CCN 147997 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)		 Jun 30, 2014
Jun 30, 2014
Jun 30, 2014
Divine Hospice & Palliative CareYorkville, IL, CCN 141690 Hospice 5% Or Greater Direct Ownership Interest (75%)
Operational/Managerial Control		 Jun 19, 2017
Jun 19, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073548483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 LINDSEY LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604406171",
            "telephone_number": "630-679-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 WEST COUNTRYSIDE PARKWAY",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "60560",
            "telephone_number": "630-882-6441",
            "fax_number": "630-882-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "SANJAY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036107028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorkville, IL

Sources for this page

Verify at the official NPI Registry.