1. Home
  2. Directory
  3. Illinois
  4. Danville
  5. Family Medicine
  6. NPI Profile

ADITYA BIRBAL-JAIN MD
NPI 1255628723
Family Medicine in Danville, IL

Active since July 06, 2011PECOS EnrolledAccepts Medicare Assignment
311 W. FAIRCHILD ST., DANVILLE, IL 61832(217) 431-7600(217) 431-7850 Get Directions Write a Review

NPPES record last updated: December 4, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Aditya Birbal-jain Md NPPES

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

ADITYA BIRBAL-JAIN MD (NPI 1255628723) is an individual family medicine provider in Danville, Illinois, licensed in Illinois (036133835) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Carle Foundation Hospital, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1255628723
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameADITYA BIRBAL-JAINCredential: MD
Location Address311 W. FAIRCHILD ST.Danville, IL 61832
Mailing Address611 W. Park St., BwpcUrbana, IL 61801-2500 · (217) 383-6792 · Fax (217) 431-7850
Phone(217) 431-7600
Fax(217) 431-7850
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 6, 2011
Last NPPES UpdateDecember 4, 2014
✔ NPI 1255628723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036133835
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
311 W. FAIRCHILD ST., Danville, IL 61832
Open in Google Maps ↗

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

Aditya Birbal-jain Md 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 ID1456577501
PECOS Enrollment IDI20140724002627
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 6

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.
297 services144 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.
57 services53 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
30 services30 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
14 services14 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
14 services14 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Carle Foundation Hospital

Acute Care Hospitals · Urbana, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140091
Location611 West Park StreetUrbana, IL 61801 · Champaign County
Emergency services Birthing friendly

Carle Bromenn Medical Center

Acute Care Hospitals · Normal, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140127
Location1304 Franklin AvenueNormal, IL 61761 · Mc Lean County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61832 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers26 claims74 services$6.62 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers20 claims31 services$1.14 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers14 claims14 services$84.81 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

KERRY L HALL APRN, CNP
Nurse Practitioner (Family)
311 W. FAIRCHILD ST., FAMILY MEDICINE
DANVILLE, IL 61832
Vermilion County (217) 431-7650
SIMONE RIBBE NP
Nurse Practitioner
311 W. FAIRCHILD ST., CONVENIENT CARE
DANVILLE, IL 61832
Vermilion County (217) 431-7600
ROBIN E BLEW NP
Nurse Practitioner
311 W. FAIRCHILD ST.
DANVILLE, IL 61832
Vermilion County (217) 431-7600
DR. LU YE MD
Family Medicine
311 W. FAIRCHILD ST.
DANVILLE, IL 61832
Vermilion County (217) 431-7600
TOMAS CARLOS VEGAS M.D.
Family Medicine
311 W. FAIRCHILD ST., CONVENIENT CARE
DANVILLE, IL 61832
Vermilion County (217) 431-7600
PRESLEY E PEARMAN PA-C
Physician Assistant
311 W. FAIRCHILD ST., ADULT MEDICINE
DANVILLE, IL 61832
Vermilion County (217) 431-7700
RUSSIA VEGA NP
Nurse Practitioner
311 W. FAIRCHILD ST.
DANVILLE, IL 61832
Vermilion County (217) 431-7600
VERNESHA MONTGOMERY M.D
Family Medicine
311 W. FAIRCHILD ST.
DANVILLE, IL 61832
Vermilion County (217) 431-7650

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Aditya Birbal-jain's NPI number?

The NPI number for Aditya Birbal-jain is 1255628723. It was assigned to this individual provider in the NPPES registry on July 6, 2011.

Where is Aditya Birbal-jain located?

Aditya Birbal-jain practices at 311 W. Fairchild St., Danville, IL 61832. The listed phone number is (217) 431-7600.

What is Aditya Birbal-jain's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Aditya Birbal-jain enrolled in Medicare?

Yes. Aditya Birbal-jain is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Aditya Birbal-jain affiliated with any hospitals?

According to CMS data, Aditya Birbal-jain is affiliated with Carle Foundation Hospital and Carle Bromenn Medical Center.

When was this NPI record last updated?

The NPPES record for Aditya Birbal-jain was last updated on December 4, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.