GAUTAM BORTHAKUR M.D.
NPI 1629177944
Internal Medicine - Hematology in Chicago, IL

Q: What is Gautam Borthakur's NPI number?

The NPI number for Gautam Borthakur is 1629177944. It was assigned to this individual provider in the NPPES registry on September 22, 2006.

Q: What is Gautam Borthakur's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.

Q: When was this NPI record last updated?

The NPPES record for Gautam Borthakur was last updated on August 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since September 22, 2006PECOS EnrolledAccepts Medicare Assignment

81.38/100

CMS Quality Rating

1520 W HARRISON ST, CHICAGO, IL 60607(312) 942-5904 Get Directions Write a Review

NPPES record last updated: August 18, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 18, 2026, Feb 10, 2025 (2 updates tracked since 2025).

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About Gautam Borthakur M.d. NPPES

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

GAUTAM BORTHAKUR M.D. (NPI 1629177944) is an individual hematology provider in Chicago, Illinois, licensed in Illinois (036.181720) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1629177944

Entity TypeIndividualMale

Primary Taxonomy207RH0000X

Provider Legal NameGAUTAM BORTHAKURCredential: M.D.

Location Address1520 W HARRISON STChicago, IL 60607-3106

Mailing Address1520 W Harrison StChicago, IL 60607-3106 · (312) 942-5904

Phone(312) 942-5904

Sole ProprietorNo

Medical School CMSOtherGraduated 1985

Enumeration DateSeptember 22, 2006

Last NPPES UpdateAugust 18, 20262 updates tracked since enumeration

NPPES CertifiedAugust 18, 2026

✔ NPI 1629177944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · HematologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0000X

License✔ Licensed in IL · 036.181720

Definition

An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma.

Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License 036.181720 (IL)

1520 W HARRISON ST, Chicago, IL 60607

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Other Identifiers 2

Medicaid39164102TX

Other8R9760TX · Bcbs

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gautam Borthakur 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 ID9133166473

PECOS Enrollment IDI20050408000580

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.

Medicare Billing Reassignment

Medicare enrollment records show Gautam Borthakur reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physicians Referral Service

944 mi

Multi-Specialty

1515 HOLCOMBE BLVD
Houston, TX 77030

Reassigned Medicare billing, Texas enrollment
2,675 clinicians in this Medicare group

NPI 1073574810 (713) 792-6161

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 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.

221 services36 patients

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.

203 services78 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.

192 services104 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

20 services20 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

17 services11 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.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60607 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

$183.39 typical visit price

range $60.08 – $183.39

Typical copayment $45.84 (range $15.02 – $45.84)

Most-billed visit code 99205

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.

81.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

81.25

Promoting Interoperability

100

Improvement Activities

Cost

49.97

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.

MR. JOSHUA BRYAN DUNN APRN

Nurse Practitioner (Acute Care)