Individual provider Active NPI

Narayan S Tata, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Naperville, IL
National Provider Identifier
1881648962
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
036107147 Issued in IL
Practice address
1999 Springbrook Square Dr Ste 101
Naperville, IL 60564-5946
Phone
(630) 378-4590
Fax
(630) 378-4592
NPI assigned
May 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 036107147 IL Primary

Addresses

Primary practice location

1999 Springbrook Square Dr Ste 101
Naperville, IL 60564-5946

Mailing address

PO Box 9531
Naperville, IL 60567-0531
Phone (630) 378-4590

Other identifiers 1

IdentifierTypeStateIssuer
036107147OtherILSTATE MEDICAL LICENSE

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
I20040206000113 IL Practitioner - Pain ManagementPractitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 3779476312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Northwestern University Feinberg Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1999 Springbrook SQ Dr
Suite 101
Naperville, IL 60564-5946
Phone (630) 378-4590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Sports and Pain Specialists, P.C. Pain Medicine CurrentSince Oct 15, 2005 Accepting new patients
MSPS Surgical Inc. Current Accepting new patients
Physical Medicine Center PastSince Feb 7, 2013 Accepting new patients
Shilo Enterprises PC PastSince Aug 1, 2017 Accepting new patients

Locations

1999 Springbrook Square Dr
Ste 101
Naperville, IL 60564
Phone (630) 305-3025

1 E County Line Rd
Sandwich, IL 60548
Phone (815) 786-2722

Interoperability endpoints

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1881648962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9531",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605670531",
            "telephone_number": "630-378-4590",
            "fax_number": "630-378-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 SPRINGBROOK SQUARE DR STE 101",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645946",
            "telephone_number": "630-378-4590",
            "fax_number": "630-378-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATA",
        "first_name": "NARAYAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-21",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IL",
            "license": "036107147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "036107147",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.