Kyle Raj Bhatia, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036169158 Issued in IL

Practice address

550 E Devon Ave Ste 200
Itasca, IL 60143-2639

Phone

(864) 625-3376

NPI assigned

Mar 31, 2020

Last updated

Apr 16, 2024By 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 1

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

Specialty

Dermatology

Education

Loyola University of Chicago, Stritch School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Dermatology LLCGroup PAC ID 7810256849, 17 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbhatia93741@direct.luhs.org

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.

• Oak Dermatology LLC

  • MOHS-Micrographic Surgery Physician
  • Itasca, IL
  • NPI 1487168258
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1942838289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E DEVON AVE STE 200",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601432639",
            "telephone_number": "864-625-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E DEVON AVE STE 200",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601432639",
            "telephone_number": "864-625-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATIA",
        "first_name": "KYLE",
        "middle_name": "RAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036169158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Bedolla, ATC
• Rayven Belk
• Olivia Bell
• Jennifer Beverly
• Ashish C Bhatia, M.D.
• Wendy Biela
• David Thomas Boe
• Christina Marie Bordignon
• Noah Boucekkine, PTA
• Bradley Ashpole MD LLC

• Dermatology Physician in Itasca, IL
• Providers in Itasca, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.