DR. ANKUR SETHI MD
NPI 1013172329
Internal Medicine - Interventional Cardiology in Oak Park, IL

Q: What is Ankur Sethi's NPI number?

The NPI number for Ankur Sethi is 1013172329. It was assigned to this individual provider in the NPPES registry on July 25, 2008.

Q: What is Ankur Sethi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Q: When was this NPI record last updated?

The NPPES record for Ankur Sethi was last updated on April 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 July 25, 2008PECOS EnrolledAccepts Medicare Assignment

93.71/100

CMS Quality Rating

7035 NORTH AVE, OAK PARK, IL 60302(708) 680-3800 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 9, 2024, Feb 20, 2018, Nov 13, 2017 and 2 more (5 updates tracked since 2016).

On this page

About Dr. Ankur Sethi Md NPPES

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

DR. ANKUR SETHI MD (NPI 1013172329) is an individual interventional cardiology provider in Oak Park, Illinois, licensed in Illinois (036125720) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Robert Wood Johnson University Hospital, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1013172329

Entity TypeIndividualMale

Primary Taxonomy207RI0011X

Provider Legal NameDR. ANKUR SETHICredential: MD

Location Address7035 NORTH AVEOak Park, IL 60302-1015

Mailing Address808 E Woodfield Rd Ste 100Schaumburg, IL 60173-4836 · (847) 605-9500 · Fax (847) 637-0737

Phone(708) 680-3800

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateJuly 25, 2008

Last NPPES UpdateApril 9, 20245 updates tracked since enumeration

NPPES CertifiedApril 9, 2024

✔ NPI 1013172329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RI0011X

Licenses✔ Licensed in IL · 036125720✔ Licensed in NJ · 25MA10215700

Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 036125720 (IL), 25MA10215700 (NJ)

Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X · License 036125720 (IL), 25MA10215700 (NJ)

Also ListedSpecialist/Technologist Cardiovascular · SonographyTaxonomy 246XS1301X · License 25MA10215700 (NJ)

7035 NORTH AVE, Oak Park, IL 60302

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Other Identifiers 1

Medicaid036125720IL

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ankur Sethi 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 ID6608064019

PECOS Enrollment IDI20180515001882

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 14

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.

305 services131 patients

Replacement of aortic valve through the skin and femoral artery 33361

This procedure, known as Transcatheter Aortic Valve Replacement (TAVR), involves replacing a damaged aortic valve through a small incision in the leg. A catheter is inserted into the femoral artery and guided up to the heart. The new valve is then positioned and deployed, restoring normal blood flow.

113 services113 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.

91 services90 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

87 services79 patients

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.

74 services33 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

73 services28 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.

69 services52 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.

59 services49 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

52 services52 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

43 services41 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

38 services35 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

22 services20 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel 92978

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

19 services19 patients

Insertion of tube in coronary artery for diagnosis with review by radiologist 93454

This procedure involves placing a small tube into your coronary artery. It helps to identify any blockages or issues within the artery. A radiologist, a doctor specialized in medical imaging, will review the results to ensure accurate diagnosis.

14 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Robert Wood Johnson University Hospital

Acute Care Hospitals · New Brunswick, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310038

LocationOne Robert Wood Johnson PlaceNew Brunswick, NJ 08901 · Middlesex County

Emergency services Birthing friendly

Community Medical Center

Acute Care Hospitals · Toms River, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310041

Location99 Rt 37 WestToms River, NJ 08755 · Ocean County

Emergency services Birthing friendly

Robert Wood Johnson University Hospital - Somerset

Acute Care Hospitals · Somerville, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310048

Location110 Rehill AveSomerville, NJ 08876 · Somerset County

Emergency services Birthing friendly

Centrastate Medical Center

Acute Care Hospitals · Freehold, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310111

Location901 West Main StreetFreehold, NJ 07728 · Monmouth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60302 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.

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.

93.71/100

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

Scored through an Alternative Payment Model

Quality

77.79

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 3

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

OAK PARK OPEN MRI

Clinic/Center (Magnetic Resonance Imaging (MRI))

7035 NORTH AVE
OAK PARK, IL 60302

Cook County (708) 358-1000

DR. KATHERINE HERETIS M.D.

Internal Medicine (Cardiovascular Disease)

7035 NORTH AVE
OAK PARK, IL 60302

Cook County (708) 680-3800

DR. MARK BALEK M.D.

Internal Medicine (Cardiovascular Disease)

7035 NORTH AVE
OAK PARK, IL 60302

Cook County (708) 680-3800

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 Ankur Sethi's NPI number?

The NPI number for Ankur Sethi is 1013172329. It was assigned to this individual provider in the NPPES registry on July 25, 2008.

Where is Ankur Sethi located?

Ankur Sethi practices at 7035 North Ave, Oak Park, IL 60302. The listed phone number is (708) 680-3800.

What is Ankur Sethi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Ankur Sethi enrolled in Medicare?

Yes. Ankur Sethi 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 Ankur Sethi accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Ankur Sethi 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 Ankur Sethi affiliated with any hospitals?

According to CMS data, Ankur Sethi is affiliated with Robert Wood Johnson University Hospital, Community Medical Center, Robert Wood Johnson University Hospital - Somerset and Centrastate Medical Center.

When was this NPI record last updated?

The NPPES record for Ankur Sethi was last updated on April 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.