Active NPI
Timir Sudhaker Baman, MD
- Clinical Cardiac Electrophysiology Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- 036-127197
- Practice address
- 5405 N Knoxville Ave
Peoria, IL 61614-5016 - Phone
- (309) 691-4410
- NPI assigned
- Feb 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301087231 | MI | |
| Cardiovascular Disease Physician | 207RC0000X | 4301087231 | MI | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 4301087231 | MI | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 036-127197 | IL | Primary |
Addresses
Primary practice location
5405 N Knoxville Ave
Peoria, IL 61614-5016
Mailing address
5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone (309) 691-4410
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiac Electrophysiology
- Education
- Pennsylvania State University College of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5405 N Knoxville Ave
Peoria, IL 61614-5065
Phone (309) 691-4410
Hospital & facility affiliations
- Saint Francis Medical Center
- Osf Saint Elizabeth MDL Ctr
- Osf Saint Luke Medical Center
- St Mary Medical Center
- Osf Saint Clare Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 69 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301087231 | MI | MD | Internal Medicine Physician |
| 036-127197 | IL | MD | Clinical Cardiac Electrophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Internal Medicine | Current | Accepting new patients |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
3375 N Seminary St
Galesburg, IL 61401
Phone (309) 343-5114
610 Park Ave
Pekin, IL 61554
Phone (309) 346-7776
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
5405 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-4410
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Princeton, IL
- NPI 1093308439
-
- Critical Access Hospital
- Kewanee, IL
- NPI 1871919381
-
- General Acute Care Hospital
- Peru, IL
- NPI 1588713440
-
- General Acute Care Hospital
- Galesburg, IL
- NPI 1164485363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1831230812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5405 N KNOXVILLE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145016",
"telephone_number": "309-691-4410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5405 N KNOXVILLE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145016",
"telephone_number": "309-691-4410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAMAN",
"first_name": "TIMIR",
"middle_name": "SUDHAKER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-10",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301087231",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MI",
"license": "4301087231",
"primary": false
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "MI",
"license": "4301087231",
"primary": false
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "IL",
"license": "036-127197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.