DR. KEITH BALRAM SHANKAR M.D.
NPI 1225657364
Student in an Organized Health Care Education/Training Program in Loves Park, IL

Q: What is Keith Shankar's NPI number?

The NPI number for Keith Shankar is 1225657364. It was assigned to this individual provider in the NPPES registry on April 9, 2020.

Q: What is Keith Shankar's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Keith Shankar was last updated on January 25, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 09, 2020PECOS EnrolledAccepts Medicare Assignment

7702 N ALPINE RD, LOVES PARK, IL 61111(815) 971-2000 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 5, 2023, Jan 25, 2022, Apr 9, 2020 (3 updates tracked since 2020).

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About Dr. Keith Balram Shankar M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEITH BALRAM SHANKAR M.D. (NPI 1225657364) is an individual student in an organized health care education/training program in Loves Park, Illinois and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Brooks-tlc Hospital System, Inc, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1225657364

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. KEITH BALRAM SHANKARCredential: M.D.

Location Address7702 N ALPINE RDLoves Park, IL 61111

Mailing Address7702 N Alpine Rd., Mercy Health Family Medicine ProgramLoves Park, IL 61111 · (815) 971-2000

Phone(815) 971-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateApril 9, 2020

Last NPPES UpdateJanuary 25, 20223 updates tracked since enumeration

NPPES CertifiedJanuary 25, 2022

✔ NPI 1225657364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

7702 N ALPINE RD, Loves Park, IL 61111

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Keith Balram Shankar M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173968450

PECOS Enrollment IDI20240226003695

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

49 services33 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

15 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Brooks-Tlc Hospital System, Inc

Acute Care Hospitals · Dunkirk, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330229

Location529 Central AvenueDunkirk, NY 14048 · Chautauqua County

Emergency services

Upmc Chautauqua At Wca

Acute Care Hospitals · Jamestown, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330239

Location207 Foote AvenueJamestown, NY 14701 · Chautauqua County

Emergency services Birthing friendly

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SHAFFIQ YUSUF MD

Family Medicine