Bhargav Mudda, M.D.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

036143270 Issued in IL

Practice address

420 S. Schmidt Road
Ste. 240
Bolingbrook, IL 60440-2634

Phone

(630) 312-4505

Fax

(630) 312-6651

NPI assigned

Jun 4, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dr Kamran Parsa IncGroup PAC ID 4880909308, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Dr Kamran Parsa Inc

  • Neurological Surgery Physician
  • Palmdale, CA
  • NPI 1780066373

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Conservative Care Specialists Medical Group Inc

  • Pain Medicine (Anesthesiology) Physician
  • Van Nuys, CA
  • NPI 1861539280

  Single Specialty

  NPD (past)
• Skyline Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1366140881
  NPD (past)
• Trias Global, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Newport Beach, CA
  • NPI 1518433457

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1346501699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W AVENUE M4",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511432",
            "telephone_number": "661-480-2377",
            "fax_number": "661-480-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S. SCHMIDT ROAD",
            "address_2": "STE. 240",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402634",
            "telephone_number": "630-312-4505",
            "fax_number": "630-312-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDDA",
        "first_name": "BHARGAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036143270",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": "036143270",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036143270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Moy, D.M.D.
• Nicholas S. Moy, M.D.
• Phillip Moy, DDS
• MSRS Limo Inc
• Mstechify LLC
• Helen Mary Muddamalle, NP
• Mandeep Mudhar, MA, CRC, LCPC
• Raymond B Muehling, DDS
• Jessica Munoz, FNP-BC
• Jo Ann Murphy

• Pain Medicine (Anesthesiology) Physician in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.