Sanjeev Balamohan, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

036145758 Issued in IL

Practice address

1875 Dempster St Ste 301
Park Ridge, IL 60068-1127

Phone

(847) 685-1000

Fax

(847) 685-6685

NPI assigned

Jun 19, 2013

Sex

Male

Sole proprietor

Yes

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

Specialty

Otolaryngology

Education

Indiana University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest ENT Alliance PLLCGroup PAC ID 5294276259, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
• Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score

76.39 of 100Reported as group

Quality

52.78

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Midwest ENT Alliance PLLC

  • Otolaryngology Physician
  • Orland Park, IL
  • NPI 1588449458
  Medicare reassignment Care Compare group NPD
• Ear, Nose and Throat Center S.C.

  • Audiologist
  • Park Ridge, IL
  • NPI 1770643710
  Medicare reassignment NPD
• Bastian Voice Institute, LLC

  • Otolaryngology Physician
  • Downers Grove, IL
  • NPI 1922122571
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation
• Advocate North Side Health Network

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1912014564
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1952740318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE 301",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681127",
            "telephone_number": "847-685-1000",
            "fax_number": "847-685-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE 301",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681127",
            "telephone_number": "847-685-1000",
            "fax_number": "847-685-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAMOHAN",
        "first_name": "SANJEEV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "TRN19036",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036145758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Robert Baker, MD
• Matthew Robert Ellsworth Baker, MD
• Molly Baker, PA-C
• Rachel Baker
• Todd Abram Baker, M.D.
• Geralyn Marie Balazs, N.C.T.M.B., L.M.T.
• Devesh Sanjeev Ballal
• James L Ballard, CSA
• Jonathan Hartley Ballard, MD
• Alfonso Allan M Balleza II

• Otolaryngology Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.