Samir Bhalla, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

036138458 Issued in IL

Practice address

4415 Harrison St Ste 300
Hillside, IL 60162-1953

Phone

(630) 988-0152

Fax

(708) 632-5602

NPI assigned

Apr 12, 2012

Last updated

Dec 1, 2021By 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

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

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Elevate Care Windsor Park LLC

  dba Elevate Care Windsor Park

  • Skilled Nursing Facility
  • Chicago, IL
  • NPI 1710604764

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• South Loop Skilled Nursing Facility LLC

  dba Warren Barr South Loop

  • Skilled Nursing Facility
  • Chicago, IL
  • NPI 1225585987

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452
  Medicare reassignment NPD
• Bhallamd, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Hillside, IL
  • NPI 1710434964
  Medicare reassignment

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1922365170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 HARRISON ST STE 300",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601621953",
            "telephone_number": "708-632-5600",
            "fax_number": "708-632-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 HARRISON ST STE 300",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601621953",
            "telephone_number": "630-988-0152",
            "fax_number": "708-632-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHALLA",
        "first_name": "SAMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036138458",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036138458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Barr
• Monica Bembry
• Ashley Rose Benain
• Valerie Bennett
• Best Covid Care LLC
• Bhallamd, LLC
• Kristina Bogoevski
• Kimberly Grace Bokowski, PT
• Ann-Preston Bosher, DPT
• Kyle Boyd, ATC

• Geriatric Medicine (Internal Medicine) Physician in Hillside, IL
• Providers in Hillside, IL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.