Kiran Bhaskar Khanolkar, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036147967 Issued in IL

Practice address

640 W Washington St
Pittsfield, IL 62363-1350

Phone

(217) 285-2113

NPI assigned

May 27, 2005

Last updated

Nov 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in IA, TX, IL3 enrollments

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 3

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as virtual group

Quality

0

Improvement activities

0

Cost

0

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

76.18

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment NPD
• Iowa Emergency Physicians LLP

  • Emergency Medicine Physician
  • Waterloo, IA
  • NPI 1386879427
  Medicare reassignment NPD
• Jackson County Public Hospital

  dba Jackson County Regional Health Center

  • Medicare Defined Swing Bed Hospital Unit
  • Maquoketa, IA
  • NPI 1326002643
  Medicare reassignment NPD
• Jackson County Public Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Maquoketa, IA
  • NPI 1689705949
  Medicare reassignment NPD
• Odessa Physician Associates, PLLC

  • Emergency Medicine Physician
  • Odessa, TX
  • NPI 1457398364
  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  dba Pine Ridge IHS Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Iowa Emergency Physicians LLP

  • Emergency Medicine Physician
  • Keokuk, IA
  • NPI 1518354810
  NPD
• Jackson County Public Hospital

  dba Jackson County Regional Health Center

  • Skilled Nursing Facility
  • Maquoketa, IA
  • NPI 1164486551
  NPD
• Pine Ridge Indian Health Service Hospital

  dba LaCreek District Clinic

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  dba Wanblee Health Center

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD
• Emergency Department Associates, P.C.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1659319754
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1902809536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W WASHINGTON ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631350",
            "telephone_number": "217-285-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W WASHINGTON ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631350",
            "telephone_number": "217-285-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANOLKAR",
        "first_name": "KIRAN",
        "middle_name": "BHASKAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036147967",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33370",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI-CARE GROUP NUMBER",
            "identifier": "421527584",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O278374",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421527584003",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209202605",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "42152758407",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "33626",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sarah Jane Knight, DPT
• Dakota Lammy, MD
• Lanhum Chiropractic, Inc (Lanhum Chiropractic)
• Christopher Lanhum, DC
• Timothy J Leahy, O.D.

• Emergency Medicine Physician in Pittsfield, IL
• Providers in Pittsfield, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.