Individual provider Active NPI

Nikhil Bhargava, DO

  • Gastroenterology Physician
  • Bourbonnais, IL
National Provider Identifier
1568649382
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036119634 Issued in IL
Practice address
1615 N Convent St
Ste. 1
Bourbonnais, IL 60914-1081
Phone
(815) 937-5200
Fax
(815) 937-2063
NPI assigned
Jan 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036119634 IL Primary

Addresses

Primary practice location

1615 N Convent St
Ste. 1
Bourbonnais, IL 60914-1081

Mailing address

1615 N Convent St
Ste. 1
Bourbonnais, IL 60914-1081
Phone (815) 937-5200

Other identifiers 1

IdentifierTypeStateIssuer
036119634MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DDC@directaddress.net Direct

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
I20081218000061 IL Practitioner - Gastroenterology 3173685625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Midwestern University, Chicago College of Osteopathic Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Digestive Diseases Consultants of Kankakee SCGroup PAC ID 3476543646, 14 clinicians

Practice addresses (Care Compare)

1615 N Convent St
Suite 1
Bourbonnais, IL 60914-1081
Phone (815) 937-5200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy148
Upper gastrointestinal (GI) endoscopy for acid reflux142

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Diseases Consultants of Kankakee, SC Gastroenterology CurrentSince Dec 1, 2008 Accepting new patients
Rush University Medical Group Past Accepting new patients

Locations

1615 N Convent St
Ste 1
Bourbonnais, IL 60914
Phone (815) 602-8253

1615 N Convent St
Bourbonnais, IL 60914
Phone (815) 602-8253

1890 Silver Cross Blvd
Ste 225
New Lenox, IL 60451
Phone (815) 937-5200

Organizations & group practices 2

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": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1568649382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 N CONVENT ST",
            "address_2": "STE. 1",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141081",
            "telephone_number": "815-937-5200",
            "fax_number": "815-937-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 N CONVENT ST",
            "address_2": "STE. 1",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141081",
            "telephone_number": "815-937-5200",
            "fax_number": "815-937-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHARGAVA",
        "first_name": "NIKHIL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-23",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036119634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119634",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DDC@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1615 N Convent St",
            "address_2": "Ste. 1",
            "city": "Bourbonnais",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609141081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.