Poornima Anil Panjwani, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085.003291 Issued in IL

Practice address

329 Remington Blvd Ste 205
Bolingbrook, IL 60440-5817

Phone

(630) 226-1130

NPI assigned

Jun 8, 2009

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain and Spine Institute, LLCGroup PAC ID 7618979170, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Pain & Spine Institute, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Joliet, IL
  • NPI 1578610176
  Medicare reassignment Care Compare group NPD
• Gateway Spine and Pain Physicians, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Bolingbrook, IL
  • NPI 1104013473
  Medicare reassignment
• Pain & Spine Institute, LLC

  • Durable Medical Equipment & Medical Supplies
  • Hinsdale, IL
  • NPI 1871386276
  NPD

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1932335627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 REMINGTON BLVD STE 205",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405817",
            "telephone_number": "503-862-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 REMINGTON BLVD STE 205",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405817",
            "telephone_number": "630-226-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANJWANI",
        "first_name": "POORNIMA",
        "middle_name": "ANIL",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "085003291",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.003291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Palmer, M.S. CCC-SLP
• Christian Joy Lazaro Pangan
• Jason Panick, DPT
• Ann Panicker, PHARM.D
• Sumitha V Panicker, M.D.
• George Peter Papadopoulos, DC, ATC/L, RKT
• Brandon Michael Pardi, M.D.
• Janemarie K Parker, PT
• Stephanie Parks, PT, DPT
• Maria Rowena Napenas Partido, PT, DPT

• Medical Physician Assistant in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.