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KUSHAL BIKRAM BANIYA MD
NPI 1285201061
Internal Medicine in Chicago, IL

Active since June 09, 2021PECOS Enrolled
4646 N MARINE DR STE 7100, CHICAGO, IL 60640(773) 564-5225(773) 564-5226 Get Directions Write a Review

NPPES record last updated: June 9, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Kushal Bikram Baniya Md NPPES

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

KUSHAL BIKRAM BANIYA MD (NPI 1285201061) is an individual internal medicine provider in Chicago, Illinois, licensed in Illinois (125078419) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285201061
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKUSHAL BIKRAM BANIYACredential: MD
Location Address4646 N MARINE DR STE 7100Chicago, IL 60640-5759
Mailing Address5917 Inverness DrFarmington, NM 87402-8704 · (773) 437-7028
Phone(773) 564-5225
Fax(773) 564-5226
Sole ProprietorNo
Enumeration DateJune 9, 2021
NPPES CertifiedJune 9, 2021
✔ NPI 1285201061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 125078419
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4646 N MARINE DR STE 7100, Chicago, IL 60640
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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 (PECOS)

Kushal Bikram Baniya Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60640 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$15.77 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
1 supplier12 claims12 services$67.60 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Kushal Baniya's NPI number?

The NPI number for Kushal Baniya is 1285201061. It was assigned to this individual provider in the NPPES registry on June 9, 2021.

Where is Kushal Baniya located?

Kushal Baniya practices at 4646 N Marine Dr Ste 7100, Chicago, IL 60640. The listed phone number is (773) 564-5225.

What is Kushal Baniya's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kushal Baniya enrolled in Medicare?

Yes. Kushal Baniya is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kushal Baniya was last updated on June 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.