Kaushik Jayantilal Pandya, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-062045 Issued in IL

Practice address

17029 Harlem Ave
Tinley Park, IL 60477-2739

Phone

(708) 532-8800

Fax

(708) 532-5330

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ABHBBA/Endpoint/ABHBBA
• Direct secure messaging: kpandya276244@direct.myadvocateaurora.org

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639180800000",
    "number": "1396719803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17029 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772739",
            "telephone_number": "708-532-8800",
            "fax_number": "708-532-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17029 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772739",
            "telephone_number": "708-532-8800",
            "fax_number": "708-532-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "KAUSHIK",
        "middle_name": "JAYANTILAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2021-12-11",
        "certification_date": "2021-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-062045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062045",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpandya276244@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17029 Harlem Ave",
            "city": "Tinley Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604772739",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "17029 Harlem Ave",
            "city": "Tinley Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604772739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adelaide Violet Packard, MD
• Lynngail Page
• Gardenia Pajunar-Li, M.D.
• Elizabeth Palagi, ATC
• Michael Palencia
• Francisco Pantoja
• Kathryn Panzica
• Maria Pappas
• Jose M Paredes, M.D.
• Vincent Parisi, PT, DPT

• Pediatrics Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.