Individual provider Active NPI

Kanjani Shukla Bajgain, DO

  • Psychiatry Physician
  • Madison, WI
National Provider Identifier
1417512310
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
81736-21 Issued in WI
Practice address
208 E Olin Ave Ste 205
Madison, WI 53713-1427
Phone
(608) 251-4156
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 69004 MN
Psychiatry Physician 2084P0800X 81736-21 WI Primary

Addresses

Primary practice location

208 E Olin Ave Ste 205
Madison, WI 53713-1427

Mailing address

1265 John Q Hammons Dr
Madison, WI 53717-1921
Phone (608) 251-4156

Other names 1

  • Kanjani Shukla Bajgain Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230726000657 MN Practitioner - Psychiatry 7416290846 Reassigns benefits to 1 organization
I20250520001650 WI Practitioner - Neuropsychiatry 7416290846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

3051 Cahill Main
Fitchburg, WI 53711-7109
Phone (608) 661-7200

675 W Washington Ave
Madison, WI 53703-2637
Phone (608) 257-9700

8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69004MNMDPsychiatry Physician
81736-21WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince May 5, 2025 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Jul 1, 2023 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Jul 1, 2023 Accepting new patients

Locations

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

1265 John Q Hammons Dr
Madison, WI 53717

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.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1417512310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 JOHN Q HAMMONS DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171921",
            "telephone_number": "608-251-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E OLIN AVE STE 205",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131427",
            "telephone_number": "608-251-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJGAIN",
        "first_name": "KANJANI",
        "middle_name": "SHUKLA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "69004",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "81736-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KANJANI",
            "last_name": "SHUKLA BAJGAIN",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.