Sanjay K Garg, M.B.B.S

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036095041 Issued in IL

Practice address

116 W Buchanan Ave
Charleston, IL 61920-2522

Phone

(217) 345-7700

Fax

(217) 345-7200

NPI assigned

Jul 21, 2006

Last updated

Jul 6, 2023By 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Medicare reassignment NPD
• Sarah Bush Lincoln Health Center

  dba FCH Greenville Family Medicine Clinic

  • Rural Health Clinic/Center
  • Greenville, IL
  • NPI 1811858970
  NPD

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1679594055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372",
            "telephone_number": "217-868-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W BUCHANAN AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202522",
            "telephone_number": "217-345-7700",
            "fax_number": "217-345-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 E Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625213809",
            "country_code": "US",
            "telephone_number": "217-329-1000",
            "fax_number": "217-329-1055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARG",
        "first_name": "SANJAY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01058382A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036095041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200465180",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra D Frey, FNP
• Gandolfi Chiropractic Inc.
• Micheal Gandolfi, DR.
• Gabriella Marie Garcia, PTA
• Maria Elizabeth Garcia, LAT, ATC
• Seema Garg
• Todd E Garner, DO
• Mary Gienko
• Brian Wayne Gilbert
• Michael Gillmore, RNFA

• Pediatrics Physician in Charleston, IL
• Providers in Charleston, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.