Kunjan Satishkumar Bhakta, M.D.
Individual provider Active NPI Trauma Surgery Physician · Lake Forest, IL
NPI 1992966592 · NPPES record last updated Jan 12, 2022
Key facts
- NPI
- 1992966592
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Trauma Surgery Physician 2086S0127X
- License
- 036158123 (IL)
- Practice address
- 800 N Westmoreland Rd Ste 100700
Lake Forest, IL 60045-1673 - Phone
- (847) 234-4310
- Fax
- (224) 271-4600
- NPI assigned
- Jun 17, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- University of Michigan Medical School, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwestern Medical Faculty Foundation
Practice addresses (Care Compare)
1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500
1000 Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600
1475 E Belvidere Rd
Grayslake, IL 60030-2012
600 N Westmoreland Rd
Suite 1100
Lake Forest, IL 60045-1659
Phone (847) 535-9510
660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600
660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146
675 N Saint Clair St
Chicago, IL 60611-5975
675 N St Clair
Chicago, IL 60611-5975
800 N W Moreland Rd
Suite 102
Lake Forest, IL 60045-1687
Phone (847) 582-2104
800 N Westmoreland Rd
Suite 201
Lake Forest, IL 60045-1687
Phone (847) 535-7647
Hospital & facility affiliations
- Northwestern Lake Forest Hospital
- Northwestern Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100804001293 | CA | Practitioner - General Surgery | 3375676794 | Reassigns benefits to 1 organization |
| I20211216000782 | IL | Practitioner - General Surgery | 3375676794 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A99192 | CA | MD | Surgery Physician |
| 036158123 | IL | MD | Trauma Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current |
Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current |
Accepting new patients | |
| Acute Care Surgery Medical Group, Inc. | Surgery | Current |
Accepting new patients |
| Central Dupage Physician Group | Past | Accepting new patients |
Locations
4001 J St
Sacramento, CA 95819
Phone (916) 453-4037
150 N Jackson Ave
Ste 100
San Jose, CA 95116
Phone (408) 769-5340
Dept 5777
Carol Stream, IL 60122
Carol Stream, IL 60122
Phone (630) 933-3300
259 E Erie St
Ste 1600
Chicago, IL 60611
2701 Patriot Blvd
Glenview, IL 60026
Phone (847) 724-4536
1475 E Belvidere Rd
Ste 311
Grayslake, IL 60030
Phone (847) 535-6083
800 N Westmoreland Rd
Ste 100
Lake Forest, IL 60045
Phone (847) 535-6083
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301085694 | MI | |
| Surgery Physician | 208600000X | A99192 | CA | |
| Surgical Critical Care Physician | 2086S0102X | 4301085694 | MI | |
| Trauma Surgery Physician | 2086S0127X | 036158123 | IL | Yes |
Addresses
Primary practice location
800 N Westmoreland Rd Ste 100700
Lake Forest, IL 60045-1673
Mailing address
800 N Westmoreland Rd Ste 100700
Lake Forest, IL 60045-1673
Phone (847) 234-4310
Other practice location 1
1500 East Medical Center Drive
2nd floor Taubman Center Recp F
Ann Arbor, MI 48109-5332
Phone (734) 936-5738
Other providers in Lake Forest, IL
- Mark Allan Berk
- Samantha Berkson
- Harold G. Berner
- Stephanie Berry
- Andrea Erickson Best
- Aneri Dalia Bhansali
- Munisha Mehra Bhatia
- Seema Widhani Bhatia
- Shreenath Bishu
- Brandon Stuart Blackwood
All providers in Lake Forest, IL · Trauma Surgery Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.