NPIMap

Individual provider Active NPI

Bhavesh R Gandhi, MD

  • Family Medicine Physician
  • Joliet, IL
National Provider Identifier
1417994013
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-120708 Issued in IL
Practice address
1051 Essington Rd Ste 290
Joliet, IL 60435-2842
Phone
(815) 773-7827
Fax
(152) 548-4428
NPI assigned
Jun 1, 2006
Last updated
Mar 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 49061 WI
Family Medicine Physician 207Q00000X 036-120708 IL Primary

Addresses

Primary practice location

1051 Essington Rd Ste 290
Joliet, IL 60435-2842

Mailing address

1051 Essington Rd Ste 290
Joliet, IL 60435-2842
Phone (815) 773-7827

Other identifiers 1

IdentifierTypeStateIssuer
036120708MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080916000398 IL Practitioner - Family PracticePractitioner - Emergency MedicinePractitioner - Geriatric Medicine 6709895709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gandhi Medical Consultants S CGroup PAC ID 9931454634, 3 clinicians

Practice addresses (Care Compare)

1051 Essington Rd
Suite 290
Joliet, IL 60435-2842
Phone (815) 773-7827

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
14.55 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
48.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49061WIMDEmergency Medicine Physician
036-120708ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gandhi Medical Consultants SC Family Medicine CurrentSince Jun 1, 2018 Accepting new patients
Presence Healthcare Services Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Prohealth Medical Group Inc Family Medicine Past Accepting new patients

Locations

1051 Essington Rd
Ste 290
Joliet, IL 60435
Phone (815) 773-0099

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFFHDD/Endpoint/HFFHDD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1417994013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD STE 290",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352842",
            "telephone_number": "815-773-7827",
            "fax_number": "815-838-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD STE 290",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352842",
            "telephone_number": "815-773-7827",
            "fax_number": "152-548-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "BHAVESH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "49061",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-120708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120708",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.