Active NPI
Sandeep Khosla, M.D.
- Interventional Cardiology Physician
- Chicago, IL
National Provider Identifier
1376544312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 036-083308
- Practice address
- 1501 S California Ave
Chicago, IL 60608 - Phone
- (773) 257-6452
- NPI assigned
- Aug 1, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-083308 | IL | |
| Interventional Cardiology Physician | 207RI0011X | 036-083308 | IL | Primary |
| Cardiovascular Disease Physician | 207RC0000X | 036083308 | IL |
Addresses
Primary practice location
1501 S California Ave
Chicago, IL 60608
Mailing address
3537 Paysphere Cir
Chicago, IL 60674
Phone (708) 786-2900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-083308-2 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- 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 |
|---|---|---|---|---|
| I20100813000906 | IL | Practitioner - Cardiovascular Disease (Cardiology) | 4981738895 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mount Sinai Community Foundation
Practice addresses (Care Compare)
1401 S California Ave
Chicago, IL 60608-1858
Phone (773) 522-6656
2653 W Ogden Ave
FL 3 Suite a
Chicago, IL 60608-1647
Phone (773) 257-6672
2701 W 68TH St
Chicago, IL 60629-1813
Phone (773) 884-9000
California Ave at 15TH St
Chicago, IL 60608-1858
Phone (773) 542-2000
Hospital & facility affiliations
- Mt Sinai Hospital Medical Center
- Holy Cross Hospital
- Rush University Medical Center
- Northwestern Memorial Hospital
- Advocate Illinois Masonic Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.03 of 100
- Quality
- 71.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.89
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-083308 | IL | MD | Internal Medicine Physician |
| 036083308 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Sinai Community Foundation | Internal Medicine | Current | Accepting new patients |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients |
Locations
3537 Paysphere Cir
Chicago, IL 60674
1501 S California Ave
#7140
Chicago, IL 60608
Phone (773) 257-4758
2653 W Ogden Ave
Chicago, IL 60608
Phone (773) 257-6672
26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900
1501 S California Ave
Chicago, IL 60608
Phone (773) 257-6770
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1982657854
Internal Medicine
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1649318296
Hospital & facility affiliations 9
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": "1122854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295913600000",
"number": "1376544312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3537 PAYSPHERE CIR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60674",
"telephone_number": "708-786-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 S CALIFORNIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60608",
"telephone_number": "773-257-6452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOSLA",
"first_name": "SANDEEP",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-01",
"last_updated": "2011-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-083308",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "IL",
"license": "036-083308",
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036083308",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036-083308-2",
"state": "IL"
}
],
"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 Jan 25, 2011; 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.