Active NPI
Kushal Bikram Baniya, MD
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1285201061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 125078419
- Practice address
- 4646 N Marine Dr Ste 7100
Chicago, IL 60640-5759 - Phone
- (773) 564-5225
- Fax
- (773) 564-5226
- NPI assigned
- Jun 9, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125078419 | IL | Primary |
Addresses
Primary practice location
4646 N Marine Dr Ste 7100
Chicago, IL 60640-5759
Mailing address
5917 Inverness Dr
Farmington, NM 87402-8704
Phone (773) 437-7028
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250717004585 | NJ | Order and Referring Only - Internal Medicine | 9133522998 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1285201061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5917 INVERNESS DR",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874028704",
"telephone_number": "773-437-7028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 N MARINE DR STE 7100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405759",
"telephone_number": "773-564-5225",
"fax_number": "773-564-5226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANIYA",
"first_name": "KUSHAL",
"middle_name": "BIKRAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-09",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125078419",
"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 Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.