Sanjay Penmetcha, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036097423 Issued in IL

Practice address

30 E 15TH St
Chicago Heights, IL 60411-3459

Phone

(708) 756-5454

NPI assigned

Jul 17, 2006

Last updated

Jun 18, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uchicago Medicine Adventhealth la Grange Hospital, La Grange, IL, CCN 140065
• Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
• Bella Terra Lagrange Nursing home, La Grange, IL, CCN 145737
• Plymouth Place Nursing home, La Grange Park, IL, CCN 146128

Merit-based Incentive Payment System (MIPS)

Final score

4.78 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

15.93

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Att Medical LTD

  • Internal Medicine Physician
  • Burr Ridge, IL
  • NPI 1558785964
  Medicare reassignment Authorized official
• Veterans Administration

  • Internal Medicine Physician
  • Chicago Heights, IL
  • NPI 1518071877
  NPD (past) Authorized official

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

• Adventist Midwest Health

  • General Acute Care Hospital
  • Hinsdale, IL
  • NPI 1265465439
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth la Grange

  • General Acute Care Hospital
  • La Grange, IL
  • NPI 1407889652
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth Hinsdale

  • Psychiatric Hospital Unit
  • Hinsdale, IL
  • NPI 1447270780
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth la Grange

  • Rehabilitation Hospital Unit
  • La Grange, IL
  • NPI 1588068274
  Care Compare affiliation
• Plymouth Place, Inc.

  • Skilled Nursing Facility
  • La Grange Park, IL
  • NPI 1497884696

  Nursing home

  Care Compare affiliation
• Willow Springs Skilled Nursing Facility LLC

  dba Bella Terra Lagrange

  • Skilled Nursing Facility
  • La Grange, IL
  • NPI 1952984239

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1568489185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113459",
            "telephone_number": "708-756-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113459",
            "telephone_number": "708-756-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENMETCHA",
        "first_name": "SANJAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-097423",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036097423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036097423",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerstine Papa
• Ryan Pashia, CRNA
• Ambalal K Patel, MD
• Jashbhai M Patel, M.D.
• Ruchik Ishwar Patel, M.D.
• Leticia Perea, APN-CRNA
• Katherine A Pierce, LCSW
• Carla Piggee
• Carl Joseph Pignotti, D.D.S.
• Pioneer Concepts Inc (Broadway Terrace)

• Internal Medicine Physician in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.