STUART M SPRAGUE DO
NPI 1114947124
Internal Medicine - Nephrology in Evanston, IL

Q: What is Stuart Sprague's NPI number?

The NPI number for Stuart Sprague is 1114947124. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Q: What is Stuart Sprague's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Stuart Sprague was last updated on April 1, 2021. 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 July 20, 2006PECOS EnrolledAccepts Medicare Assignment

93.08/100

CMS Quality Rating

1000 CENTRAL ST STE 800, EVANSTON, IL 60201(847) 570-2512(847) 570-1696 Get Directions Write a Review

NPPES record last updated: April 1, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Stuart M Sprague Do NPPES

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

STUART M SPRAGUE DO (NPI 1114947124) is an individual nephrology provider in Evanston, Illinois, licensed in Illinois (036066785) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and maintains a secondary practice location in Evanston.

NPPES Registry Identity

NPI1114947124

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameSTUART M SPRAGUECredential: DO

Location Address1000 CENTRAL ST STE 800Evanston, IL 60201-1780

Mailing Address1000 Central St Ste 800Evanston, IL 60201-1780 · (847) 570-2512 · Fax (847) 570-1696

Phone(847) 570-2512

Fax(847) 570-1696

Sole ProprietorNo

Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1982

Enumeration DateJuly 20, 2006

Last NPPES UpdateApril 1, 2021

NPPES CertifiedApril 1, 2021

✔ NPI 1114947124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in IL · 036066785

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1000 CENTRAL ST STE 800, Evanston, IL 60201

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Secondary Practice Location 1

Location 12650 Ridge Ave, Division of Nephrology Rm 3213Evanston, IL 60201-1718 · Phone (847) 570-2512 · Fax (847) 570-1696

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

Stuart M Sprague Do 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 ID941274054

PECOS Enrollment IDI20040824001038

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 12

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.

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.

367 services327 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.

132 services70 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.

93 services51 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.

89 services89 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

79 services16 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

61 services61 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.

53 services52 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.

47 services38 patients

Home dialysis services per month (20 years or older) 90966

Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.

44 services14 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

37 services21 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

34 services12 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.

26 services26 patients

Hospital Affiliations CMS Care Compare 3

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

Northshore University Healthsystem - Evanston Hospital

Acute Care Hospitals · Evanston, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140010

Location2650 Ridge AveEvanston, IL 60201 · Cook County

Emergency services Birthing friendly

Swedish Hospital

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140114

Location5145 N California AveChicago, IL 60625 · Cook County

Emergency services Birthing friendly

Northwestern Memorial Hospital

Acute Care Hospitals · Chicago, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140281

Location251 E Huron StChicago, IL 60611 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60201 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.

93.08/100

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

Scored through an Alternative Payment Model

Quality

80.79

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Azathioprine, oral, 50 mg J7500

Treatment-Treatment - Miscellaneous · category RX029N

3 suppliers12 claims720 services$1.04 avg. paid by Medicare

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503

Treatment-Chemotherapy · category RH002N

1 supplier15 claims2,520 services$1.21 avg. paid by Medicare

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

10 suppliers38 claims2,063 services$0.33 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers23 claims1,590 services$0.18 avg. paid by Medicare

Mycophenolic acid, oral, 180 mg J7518

Treatment-Treatment - Miscellaneous · category RX029N

4 suppliers41 claims6,600 services$0.74 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

8 suppliers70 claims70 services$18.14 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

LESLIE S. FINKEL MD

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)