Shamita V Bansore, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036107104 Issued in IL

Practice address

3825 Highland Ave
Tower 1 Suite 2F
Downers Grove, IL 60515-1552

Phone

(630) 852-3762

Fax

(630) 852-4087

NPI assigned

Jun 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Obstetrics/Gynecology

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Midwest Women OB/Gyne LTDGroup PAC ID 8325141096, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DAIABA/Endpoint/DAIABA

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.

• Midwest Women OB-Gyne LTD

  • Obstetrics & Gynecology Physician
  • Downers Grove, IL
  • NPI 1679652523
  Medicare reassignment Care Compare group NPD Authorized official
• Women's Comprehensive Healthcare, S.C.

  • Obstetrics & Gynecology Physician
  • Hoffman Estates, IL
  • NPI 1639101033
  NPD (past)
• Women's Doc of Elgin, S. C.

  • Obstetrics & Gynecology Physician
  • Elgin, IL
  • NPI 1295763886
  NPD (past)

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

• Advocate Health and Hospitals Corporation

  dba Advocate Good Samaritan Hospital

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1700813771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 HIGHLAND AVE",
            "address_2": "TOWER 1 SUITE 2F",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151552",
            "telephone_number": "630-852-3762",
            "fax_number": "630-852-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HIGHLAND AVE",
            "address_2": "TOWER 1 SUITE 2F",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151552",
            "telephone_number": "630-852-3762",
            "fax_number": "630-852-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSORE",
        "first_name": "SHAMITA",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036107104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107104",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbansore252070@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3825 Highland Ave",
            "address_2": "Tower 1 Suite 2F",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605151552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3825 Highland Ave",
            "address_2": "Tower 1 Suite 2F",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605151552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brooklyn Bane
• Michelle Bankhead
• Takiyah Banks, RN
• Patrick J Bannon, DDS
• Joanna Giacinta Bansfield, FNP-BC
• Sara E. Banuelos, D.D.S
• Justina Baranauskaite, ND, LAC
• Barbara E. B. Myers, D.M.D., P.C.
• Natalie Christine Barbato, LPC
• Amreen Barde

• Obstetrics & Gynecology Physician in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.