Individual provider Active NPI

Mukta Pant-Purohit, M.D.

  • Hematology & Oncology Physician
  • Aurora, IL
National Provider Identifier
1457533739
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036-131867 Issued in IL
Practice address
1221 N Highland Ave
Aurora, IL 60506-1404
Phone
(630) 859-8700
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01064594A IN
Hematology & Oncology Physician 207RH0003X 036-131867 IL Primary

Addresses

Primary practice location

1221 N Highland Ave
Aurora, IL 60506-1404

Mailing address

1870 W Galena Blvd
Aurora, IL 60506-4356
Phone (630) 859-6800

Other identifiers 1

IdentifierTypeStateIssuer
036131867MedicaidIL

Other names 1

  • Mukta Pant Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OR, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20130426000460 IL Practitioner - Hematology/Oncology 8123264793 Reassigns benefits to 1 organization
I20260527003235 OR Practitioner - Hematology/Oncology 8123264793 Reassigns benefits to 1 organization
I20260612004041 FL Practitioner - Hematology/Oncology 8123264793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians
Mercy Clinic Specialists Services-Illinois LLCGroup PAC ID 1254629801, 7 clinicians

Practice addresses (Care Compare)

1775 One Healing PL
Tallahassee, FL 32308-4600
Phone (850) 431-5360

2227 Vadalabene Dr
Suite 200
Maryville, IL 62062-5824
Phone (618) 288-1140

Hospital & facility affiliations

  • Anderson Hospital Hospital, Maryville, IL, CCN 140289
  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01064594AINMDInternal Medicine Physician
036-131867ILMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Specialists Services-Illinois LLC Hematology & Oncology CurrentSince Aug 2, 2023 Accepting new patients
Mercy Clinic Surgical Specialists-Illinois LLC CurrentSince Aug 2, 2023 Accepting new patients

Locations

2227 Vadalabene Dr
Ste 200
Maryville, IL 62062
Phone (618) 288-1140

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1457533739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W GALENA BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064356",
            "telephone_number": "630-859-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061404",
            "telephone_number": "630-859-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANT-PUROHIT",
        "first_name": "MUKTA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01064594A",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036-131867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036131867",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MUKTA",
            "last_name": "PANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.