Individual provider Active NPI

Nandana C. Bhakta, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1114037413
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36060410 Issued in IL
Practice address
6283 S Archer Ave
Chicago, IL 60638-2505
Phone
(773) 585-3131
Fax
(773) 585-4565
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36060410 IL Primary

Addresses

Primary practice location

6283 S Archer Ave
Chicago, IL 60638-2505

Mailing address

6283 S Archer Ave
Chicago, IL 60638-2505
Phone (773) 585-3131

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36060410ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bhakta Medical Associates Current Accepting new patients

Locations

6283 S Archer Ave
Chicago, IL 60638
Phone (773) 585-3131

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1114037413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6283 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382505",
            "telephone_number": "773-585-3131",
            "fax_number": "773-585-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6283 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382505",
            "telephone_number": "773-585-3131",
            "fax_number": "773-585-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "NANDANA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36060410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.