PUSHPA K MAMTANI MD
NPI 1376527168
Pediatrics in Rockford, IL

Active since December 05, 2005PECOS EnrolledAccepts Medicare Assignment
5666 E STATE ST, ROCKFORD, IL 61108(815) 226-2000 Get Directions Write a Review

NPPES record last updated: March 5, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 5, 2025, Jan 25, 2023, Dec 15, 2022 and 1 more (4 updates tracked since 2021).

About Pushpa K Mamtani Md NPPES

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

PUSHPA K MAMTANI MD (NPI 1376527168) is an individual pediatrics provider in Rockford, Illinois, licensed in Illinois (36 064091) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS, maintains a secondary practice location in Ottawa, and is a graduate of Other (1978).

NPPES Registry Identity

NPI1376527168
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NamePUSHPA K MAMTANICredential: MD
Location Address5666 E STATE STRockford, IL 61108-2425
Mailing Address5666 E State StRockford, IL 61108-2425 · (815) 226-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 1978
Enumeration DateDecember 5, 2005
Last NPPES UpdateMarch 5, 20254 updates tracked since enumeration
NPPES CertifiedMarch 5, 2025
NPI 1376527168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses Licensed in IL · 36 064091 Licensed in MI · 4301503653
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
5666 E STATE ST, Rockford, IL 61108

Other Names 1

Former Name (1)Pushpa Balasubramanian Md

Secondary Practice Location 1

Location 11614 E Norris DrOttawa, IL 61350-3681 · Phone (815) 433-1010 · Fax (815) 433-0067

Other Identifiers 2

Other01932040IL · Bcbs
Medicaid036064091IL

Accepted Insurance

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

Pushpa K Mamtani 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 ID9032160395
PECOS Enrollment IDI20251218000826
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 61108 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.

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.

Specialist
5666 E STATE ST
ROCKFORD, IL 61108
Internal Medicine
5666 E STATE ST
ROCKFORD, IL 61108
Nurse Anesthetist, Certified Registered
5666 E STATE ST
ROCKFORD, IL 61108
Nurse Practitioner (Family)
5666 E STATE ST
ROCKFORD, IL 61108
Radiology (Diagnostic Radiology)
5666 E STATE ST
ROCKFORD, IL 61108
Nurse Practitioner (Family)
5666 E STATE ST
ROCKFORD, IL 61108
Physical Therapist
5666 E STATE ST
ROCKFORD, IL 61108
Internal Medicine
5666 E STATE ST
ROCKFORD, IL 61108

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 Pushpa Mamtani's NPI number?

The NPI number for Pushpa Mamtani is 1376527168. It was assigned to this individual provider in the NPPES registry on December 5, 2005. The provider is also known as Pushpa Balasubramanian MD.

Where is Pushpa Mamtani located?

Pushpa Mamtani practices at 5666 E State St, Rockford, IL 61108. The listed phone number is (815) 226-2000.

What is Pushpa Mamtani's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Pushpa Mamtani enrolled in Medicare?

Yes. Pushpa Mamtani 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.

What insurance does Pushpa Mamtani accept?

Health plans from Group Health Cooperative-SCW list Pushpa Mamtani as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pushpa Mamtani was last updated on March 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.