Individual provider Active NPI

Balaganesh Natarajan

  • Internal Medicine Physician
  • Urbana, IL
National Provider Identifier
1720835606
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.083361 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2501
Phone
(217) 383-3311
NPI assigned
Apr 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.083361 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2501

Mailing address

407 Larchmont Way
Mountain Top, PA 18707-2050
Phone (570) 574-9195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20250826000148 SD Order and Referring Only - NeurologyPractitioner - Neurology 9032619879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.083361ILMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: bnatarajanmd411959@carlehiedirect.net

NPI Registry JSON

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1720835606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 LARCHMONT WAY",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187072050",
            "telephone_number": "570-574-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-383-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATARAJAN",
        "first_name": "BALAGANESH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.083361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.