SUPARNA BASU MD
NPI 1679719777
Psychiatry & Neurology - Psychiatry in Peoria, IL

Q: What is Suparna Basu's NPI number?

The NPI number for Suparna Basu is 1679719777. It was assigned to this individual provider in the NPPES registry on December 21, 2008.

Q: What is Suparna Basu's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Suparna Basu was last updated on December 23, 2020. 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.

Active since December 21, 2008PECOS Enrolled

228 NE JEFFERSON AVE, PEORIA, IL 61603(309) 671-8005 Get Directions Write a Review

NPPES record last updated: December 23, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 23, 2020, Feb 6, 2019, Feb 1, 2019 and 1 more (4 updates tracked since 2016).

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About Suparna Basu Md NPPES

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

SUPARNA BASU MD (NPI 1679719777) is an individual psychiatry provider in Peoria, Illinois, licensed in Illinois (036.147481) and active in the NPI registry since December 2008. She is enrolled in Medicare PECOS and maintains a secondary practice location in Mountain View.

NPPES Registry Identity

NPI1679719777

Entity TypeIndividualFemale

Primary Taxonomy2084P0800X

Provider Legal NameSUPARNA BASUCredential: MD

Location Address228 NE JEFFERSON AVEPeoria, IL 61603-3802

Mailing Address150 Saxon Woods RdScarsdale, NY 10583-7804 · (516) 232-5732

Phone(309) 671-8005

Sole ProprietorYes

Enumeration DateDecember 21, 2008

Last NPPES UpdateDecember 23, 20204 updates tracked since enumeration

NPPES CertifiedDecember 23, 2020

✔ NPI 1679719777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in IL · 036.147481

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

228 NE JEFFERSON AVE, Peoria, IL 61603

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Secondary Practice Location 1

Location 1303 Bryant StMountain View, CA 94041-1552 · Phone (888) 995-2230 · Fax (650) 242-7520

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CareSource, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Suparna Basu 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 61603 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

$168.44 typical visit price

range $54.80 – $168.44

Typical copayment $42.11 (range $13.70 – $42.11)

Most-billed visit code 99205

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 14

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

DR. GEORGE KENNETH SHOTICK JR. M.D.

Family Medicine