Individual provider Active NPI

Sanmit Kumar Basu, MD

  • Pediatric Cardiology Physician
  • Chicago, IL
National Provider Identifier
1376709519
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
036122876 Issued in IL
Practice address
5841 S Maryland Ave # Mc4051
Chicago, IL 60637-1443
Phone
(773) 702-1061
NPI assigned
Aug 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 35123781 OH
Pediatric Cardiology Physician 2080P0202X 036122876 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc4051
Chicago, IL 60637-1443

Mailing address

150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965

Other identifiers 1

IdentifierTypeStateIssuer
0104564MedicaidOH

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181102002217 IL Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 5597980243 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036122876ILMDPediatric Cardiology Physician
35123781OHMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Sep 20, 2018 Accepting new patients
The University of Chicago Medical Center CurrentSince Sep 20, 2018 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Interoperability endpoints

  • Direct secure messaging: sbasu167048@uchospital.direct-ci.com
  • Direct secure messaging: sanmit.basu@mmhs.medicity.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1376709519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC4051",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASU",
        "first_name": "SANMIT",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OH",
            "license": "35123781",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IL",
            "license": "036122876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104564",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.