Individual provider Active NPI

Paru P Kathpalia, MD

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1689864787
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
36-129369 Issued in IL
Practice address
1101 S Canal St
Chicago, IL 60607-4901
Phone
(312) 986-0110
Fax
(312) 663-1010
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 36-129369 IL Primary

Addresses

Primary practice location

1101 S Canal St
Chicago, IL 60607-4901

Mailing address

1101 S Canal St
Chicago, IL 60607-4901
Phone (312) 986-0110

Other identifiers 1

IdentifierTypeStateIssuer
036129369MedicaidIL

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
I20120824000344 IL Practitioner - Nephrology 7517130594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Michigan Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Nephrology LTDGroup PAC ID 2668569351, 4 clinicians

Practice addresses (Care Compare)

1101 S Canal St
Chicago, IL 60607-4901
Phone (312) 986-0110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36-129369ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Nephrology, LTD. Nephrology CurrentSince Jul 9, 2012 Accepting new patients

Locations

1717 S Wabash Ave
Chicago, IL 60616
Phone (312) 913-0000

1101 S Canal St
Ste 5
Chicago, IL 60607

2277 W Howard St
Chicago, IL 60645
Phone (773) 262-7147

1101 S Canal St
Chicago, IL 60607
Phone (312) 345-0110

Interoperability endpoints

  • Direct secure messaging: pkathpalia33512@direct.acumenmd.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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1689864787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S CANAL ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074901",
            "telephone_number": "312-986-0110",
            "fax_number": "312-663-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S CANAL ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074901",
            "telephone_number": "312-986-0110",
            "fax_number": "312-663-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHPALIA",
        "first_name": "PARU",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "36-129369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036129369",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.