Individual provider Active NPI

Pranusha Naidu Baxi, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bolingbrook, IL
National Provider Identifier
1487187506
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
1487187506 Issued in IL
Practice address
420 S Schmidt Rd
Suite 110
Bolingbrook, IL 60440
Phone
(450) 563-0312
NPI assigned
Apr 5, 2017
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pain Medicine (Anesthesiology) Physician 207LP2900X 1487187506 IL Primary

Addresses

Primary practice location

420 S Schmidt Rd
Suite 110
Bolingbrook, IL 60440

Mailing address

420 S Schmidt Road
Suite 110
Bolingbrook, IL 60440
Phone (630) 312-4562

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
I20220721000700 IL Practitioner - Pain Management 7911252432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Saint Louis University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chicagoland Pain Management Institute IncGroup PAC ID 1850536830, 8 clinicians

Practice addresses (Care Compare)

420 S Schmidt Rd
Suite 110
Bolingbrook, IL 60440-1756
Phone (630) 312-4562

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1487187506ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chicagoland Pain Management Institute, Inc. CurrentSince Jul 1, 2022 Accepting new patients

Locations

420 N Schmidt Rd
Ste 125
Bolingbrook, IL 60440
Phone (630) 312-4500

26358 Network Pl
Chicago, IL 60673

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13549/brand/1/csg/1/fhir/r4
  • Direct secure messaging: pranusha.naidu.1@13549.direct.athenahealth.com

Organizations & group practices 1

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 5

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1487187506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S SCHMIDT ROAD",
            "address_2": "SUITE 110",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60440",
            "telephone_number": "630-312-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S SCHMIDT RD",
            "address_2": "SUITE 110",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60440",
            "telephone_number": "450-563-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXI",
        "first_name": "PRANUSHA",
        "middle_name": "NAIDU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "1487187506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.