Individual provider Active NPI

Shiva Bhattarai, M.D

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1194013573
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.060375 Issued in IL
Practice address
836 W Wellington Ave
1312
Chicago, IL 60657-5147
Phone
(773) 296-5051
NPI assigned
Jul 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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 125.060375 IL Primary

Addresses

Primary practice location

836 W Wellington Ave
1312
Chicago, IL 60657-5147

Mailing address

856 W Nelson St
Apt 1305
Chicago, IL 60657-5152
Phone (773) 610-2997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180628002532 TX Practitioner - Internal Medicine 3274753140 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usacs Integrated Acute Care Services of Texas, PLLC 398 clinicians
Leading Edge Emergency Physicians, Inc 31 clinicians

Practice addresses (Care Compare)

1500 Red River St
Austin, TX 78701-1918
Phone (512) 324-0150

16088 San Pedro Ave
San Antonio, TX 78232-2251
Phone (210) 402-4092

201 Seton Pkwy
Round Rock, TX 78665-8000
Phone (512) 324-4000

260 Cully Dr
Kerrville, TX 78028-5950
Phone (830) 258-7747

3501 Mills Ave
Austin, TX 78731-6309
Phone (512) 324-1017

Hospital & facility affiliations

  • Ascension Seton Williamson Hospital, Round Rock, TX, CCN 670041
  • Dell Seton Med Center at the University of TX Hospital, Austin, TX, CCN 450124
  • The Hospitals of Providence Horizon City Campus Hospital, Horizon City, TX, CCN 670124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.060375ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Integrated Acute Care Services of Texas, PLLC Internal Medicine CurrentSince Sep 24, 2024 Accepting new patients
Leading Edge Emergency Physicians, Inc CurrentSince Oct 20, 2024 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Apr 16, 2019 Accepting new patients
Leading Edge Emergency Physicians, Inc CurrentSince Oct 20, 2024 Accepting new patients
Ascension Seton Past Accepting new patients

Locations

11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

201 Seton Pkwy
Round Rock, TX 78665
Phone (512) 324-1010

16088 San Pedro Ave
San Antonio, TX 78232
Phone (210) 402-4092

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1194013573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 W NELSON ST",
            "address_2": "APT 1305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575152",
            "telephone_number": "773-610-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "address_2": "1312",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-296-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATTARAI",
        "first_name": "SHIVA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.060375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.