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DR. RAJIV KANDALA M.D.
NPI 1376608059
Family Medicine in Chicago, IL

Active since December 24, 2006PECOS EnrolledAccepts Medicare Assignment
89.92/100
CMS Quality Rating
7531 S. STONY ISLAND AVE, #164, CHICAGO, IL 60649(773) 947-2831(773) 947-7500 Get Directions Write a Review

NPPES record last updated: August 2, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 2, 2022, Jun 11, 2021 (2 updates tracked since 2021).

About Dr. Rajiv Kandala M.d. NPPES

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

DR. RAJIV KANDALA M.D. (NPI 1376608059) is an individual family medicine provider in Chicago, Illinois, licensed in Illinois (036109208) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Roseland Community Hospital, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1376608059
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. RAJIV KANDALACredential: M.D.
Location Address7531 S. STONY ISLAND AVE, #164Chicago, IL 60649-3954
Mailing Address7531 S. Stony Island Ave, #164Chicago, IL 60649-3954 · (773) 947-2831 · Fax (773) 947-7500
Phone(773) 947-2831
Fax(773) 947-7500
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateDecember 24, 2006
Last NPPES UpdateAugust 2, 20222 updates tracked since enumeration
NPPES CertifiedAugust 2, 2022
✔ NPI 1376608059 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 · 036109208
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.
7531 S. STONY ISLAND AVE, Chicago, IL 60649
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Other Identifiers 1

Medicaid036109208IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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

Dr. Rajiv Kandala 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 ID2062302094
PECOS Enrollment IDI20040316000195
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
732 services153 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
118 services33 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
93 services80 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
18 services16 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
17 services16 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
16 services14 patients

Hospital Affiliations CMS Care Compare 5

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

Roseland Community Hospital

Acute Care Hospitals · Chicago, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140068
Location45 W 111th StreetChicago, IL 60628 · Cook County
Emergency services Birthing friendly

Loretto Hospital

Acute Care Hospitals · Chicago, IL
OwnershipVoluntary non-profit - Other
CMS Certification Number140083
Location645 South Central AveChicago, IL 60644 · Cook County
Emergency services

Thorek Memorial Hospital

Acute Care Hospitals · Chicago, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number140115
Location850 W Irving Park RdChicago, IL 60613 · Cook County
Emergency services

Jackson Park Hospital

Acute Care Hospitals · Chicago, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number140177
Location7531 S Stony Island AveChicago, IL 60649 · Cook County
Emergency services

South Shore Hospital

Acute Care Hospitals · Chicago, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number140181
Location8012 South Crandon AvenueChicago, IL 60617 · Cook County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60649 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.92/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality95.01
Improvement Activities40
Cost39.71

Reported Quality Measures

Advance Care Plan
100%538 patients5/55-star benchmark: 100%
Dementia: Functional Status Assessment
100%59 patients
Documentation of Current Medications in the Medical Record
100%1,112 patients5/55-star benchmark: 100%
Falls: Plan of Care
100%115 patients
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
100%127 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
100%126 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 11

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
1 supplier15 claims32 services$5.58 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
1 supplier17 claims460 services$7.09 avg. paid by Medicare
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446
DME-Medical/Surgical Supplies · category DA023N
1 supplier14 claims2,079 services$0.38 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
2 suppliers19 claims556 services$5.05 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
2 suppliers18 claims8,809 services$0.35 avg. paid by Medicare
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty E0181
DME-Other DME · category DE000N
1 supplier13 claims13 services$11.33 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 Rajiv Kandala's NPI number?

The NPI number for Rajiv Kandala is 1376608059. It was assigned to this individual provider in the NPPES registry on December 24, 2006.

Where is Rajiv Kandala located?

Rajiv Kandala practices at 7531 S. Stony Island Ave #164, Chicago, IL 60649. The listed phone number is (773) 947-2831.

What is Rajiv Kandala's specialty?

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

Is Rajiv Kandala enrolled in Medicare?

Yes. Rajiv Kandala 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 Rajiv Kandala accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Rajiv Kandala 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.

Is Rajiv Kandala affiliated with any hospitals?

According to CMS data, Rajiv Kandala is affiliated with Roseland Community Hospital, Loretto Hospital, Thorek Memorial Hospital, Jackson Park Hospital and South Shore Hospital.

When was this NPI record last updated?

The NPPES record for Rajiv Kandala was last updated on August 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.