NPIMap

Individual provider Active NPI

Sumitha V Panicker, M.D.

  • Internal Medicine Physician
  • Bolingbrook, IL
National Provider Identifier
1528279577
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125049037 Issued in IL
Practice address
235 Remington Blvd
Ste K
Bolingbrook, IL 60440-5826
Phone
(630) 914-5153
Fax
(630) 914-5157
NPI assigned
May 24, 2007
Last updated
Jan 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125049037 IL Primary

Addresses

Primary practice location

235 Remington Blvd
Ste K
Bolingbrook, IL 60440-5826

Mailing address

620 N River Rd
Ste 102
Naperville, IL 60563-8950
Phone (630) 355-4755

Other names 1

  • Sumitha S Nair Former name

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
I20081006000274 IL Practitioner - Internal Medicine 3870661788 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1414 S Richmond Ave
Willowbrook, IL 60527-1922
Phone (630) 312-2263

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.29 of 100Reported as group
Quality
94.18
Promoting interoperability
100
Improvement activities
40
Cost
69.24

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125049037ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Internists S.C. Internal Medicine CurrentSince Apr 1, 2010 Accepting new patients
Premier Internists of Naperville Inc. Internal Medicine CurrentSince Mar 3, 2018 Accepting new patients
Panicker Internal Medicine Inc Internal Medicine CurrentSince May 27, 2024 Accepting new patients

Locations

235 Remington Blvd
Ste K
Bolingbrook, IL 60440
Phone (630) 914-5153

620 N River Rd
Ste 102
Naperville, IL 60563
Phone (630) 355-4755

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1528279577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N RIVER RD",
            "address_2": "STE 102",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638950",
            "telephone_number": "630-355-4755",
            "fax_number": "630-355-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 REMINGTON BLVD",
            "address_2": "STE K",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405826",
            "telephone_number": "630-914-5153",
            "fax_number": "630-914-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANICKER",
        "first_name": "SUMITHA",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125049037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUMITHA",
            "last_name": "NAIR",
            "middle_name": "S",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.