DR. KALPESH M PATEL M.D.
NPI 1154386506
Internal Medicine in Plainfield, IL

Q: What is Kalpesh Patel's NPI number?

The NPI number for Kalpesh Patel is 1154386506. It was assigned to this individual provider in the NPPES registry on April 19, 2006.

Q: What is Kalpesh Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Kalpesh Patel was last updated on April 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 April 19, 2006PECOS EnrolledAccepts Medicare Assignment

95.78/100

CMS Quality Rating

12624 S ROUTE 59, PLAINFIELD, IL 60585(815) 577-6446(815) 577-6331 Get Directions Write a Review

NPPES record last updated: April 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 13, 2023, Jul 8, 2020 (2 updates tracked since 2020).

On this page

About Dr. Kalpesh M Patel M.d. NPPES

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

DR. KALPESH M PATEL M.D. (NPI 1154386506) is an individual internal medicine provider in Plainfield, Illinois, licensed in Illinois (036108691) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Presence Saint Joseph Medical Center, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1154386506

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. KALPESH M PATELCredential: M.D.

Location Address12624 S ROUTE 59Plainfield, IL 60585-5448

Mailing Address12624 S Route 59Plainfield, IL 60585-5448 · (815) 577-6446 · Fax (815) 577-6331

Phone(815) 577-6446

Fax(815) 577-6331

Sole ProprietorYes

Medical School CMSOtherGraduated 2000

Enumeration DateApril 19, 2006

Last NPPES UpdateApril 13, 20232 updates tracked since enumeration

NPPES CertifiedApril 13, 2023

✔ NPI 1154386506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036108691

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

12624 S ROUTE 59, Plainfield, IL 60585

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Other Identifiers 4

Other9932322IL · Bcbs

OtherP00258693IL · Rr Medicare

Medicaid036108691IL

Other14D1045386IL · Clia

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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. Kalpesh M Patel 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 ID9739085283

PECOS Enrollment IDI20031208000509

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 21

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 nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

509 services131 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

417 services108 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.

163 services68 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

145 services49 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

135 services131 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

107 services95 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

89 services57 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

80 services50 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

78 services74 patients

Transitional care management services for problem of high complexity 99496

53 services53 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

40 services18 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.

37 services13 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

35 services35 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

33 services33 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

30 services30 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.

25 services18 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.

18 services13 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

18 services15 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.

17 services16 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

13 services11 patients

Nursing facility discharge management, more than 30 minutes 99316

Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Presence Saint Joseph Medical Center

Acute Care Hospitals · Joliet, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140007

Location333 N Madison StJoliet, IL 60435 · Will County

Emergency services Birthing friendly

Copley Memorial Hospital

Acute Care Hospitals · Aurora, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140029

Location2000 Ogden AvenueAurora, IL 60504 · Kane County

Emergency services Birthing friendly

Edward Hospital

Acute Care Hospitals · Naperville, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140231

Location801 South WashingtonNaperville, IL 60540 · Du Page County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60585 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

$137.43 typical visit price

range $59.81 – $181.38

Typical copayment $34.35 (range $14.95 – $45.34)

Most-billed visit code 99204

Established Patient

$105.07 typical visit price

range $19.15 – $147.12

Typical copayment $26.26 (range $4.78 – $36.78)

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.

95.78/100

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

Scored through an Alternative Payment Model

Quality

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

73%631 patients2/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

96%895 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

16%73 patients1/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

87%127 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

87%291 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

23%289 patients1/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

70%291 patients3/55-star benchmark: 100%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 1% · 73 patients

7%73 patients3/55-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 28

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

11 suppliers22 claims78 services$6.64 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers12 claims19 services$29.22 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers11 claims48 services$1.97 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 suppliers11 claims5,544 services$0.32 avg. paid by Medicare

Commode chair, mobile or stationary, with fixed arms E0163

DME-Other DME · category DE000N

3 suppliers15 claims15 services$45.87 avg. paid by Medicare

Gel or gel-like pressure pad for mattress, standard mattress length and width E0185

DME-Other DME · category DE000N

1 supplier17 claims17 services$141.90 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers102 claims102 services$47.12 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261

DME-Hospital Beds · category DB000N

1 supplier11 claims11 services$45.86 avg. paid by Medicare

Powered pressure-reducing air mattress E0277

DME-Hospital Beds · category DB000N

1 supplier11 claims11 services$143.29 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers17 claims17 services$13.18 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

1 supplier12 claims12 services$45.97 avg. paid by Medicare

Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each E0955

DME-Wheelchairs · category DD021N

1 supplier11 claims11 services$10.72 avg. paid by Medicare

Manual wheelchair accessory, wheel lock brake extension (handle), each E0961

DME-Wheelchairs · category DD021N

1 supplier41 claims82 services$16.90 avg. paid by Medicare

Manual wheelchair accessory, anti-tipping device, each E0971

DME-Wheelchairs · category DD021N

3 suppliers49 claims98 services$22.71 avg. paid by Medicare

Wheelchair accessory, positioning belt/safety belt/pelvic strap, each E0978

DME-Wheelchairs · category DD021N

1 supplier37 claims37 services$20.45 avg. paid by Medicare

Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each E1226

DME-Wheelchairs · category DD021N

1 supplier11 claims11 services$31.29 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

6 suppliers40 claims40 services$58.35 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$28.52 avg. paid by Medicare

Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches E2201

DME-Wheelchairs · category DD021N

1 supplier20 claims20 services$252.16 avg. paid by Medicare

General use wheelchair seat cushion, width less than 22 inches, any depth E2601

DME-Wheelchairs · category DD021N

3 suppliers42 claims42 services$33.75 avg. paid by Medicare

General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware E2611

DME-Wheelchairs · category DD021N

3 suppliers46 claims46 services$133.16 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

3 suppliers12 claims12 services$19.76 avg. paid by Medicare

Standard hemi (low seat) wheelchair K0002

DME-Wheelchairs · category DD000N

1 supplier243 claims243 services$27.93 avg. paid by Medicare

Lightweight wheelchair K0003

DME-Wheelchairs · category DD000N

4 suppliers84 claims86 services$23.35 avg. paid by Medicare

Heavy duty wheelchair K0006

DME-Wheelchairs · category DD000N

1 supplier13 claims13 services$40.91 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

2 suppliers334 claims334 services$7.52 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

2 suppliers14 claims14 services$28.86 avg. paid by Medicare

Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0823

DME-Wheelchairs · category DD009N

1 supplier15 claims15 services$102.52 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 3

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

DR. SHEFALI PATEL D.D.S.

Dentist (General Practice)

12624 S ROUTE 59
PLAINFIELD, IL 60585

Will County (815) 577-0900

IVORY DENTAL

Dentist (General Practice)

12624 S ROUTE 59
PLAINFIELD, IL 60585

Will County (815) 577-0900

ADVANCED INTEGRATIVE MEDICINE

Internal Medicine

12624 S ROUTE 59
PLAINFIELD, IL 60585

Will County (815) 577-6446

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 Kalpesh Patel's NPI number?

The NPI number for Kalpesh Patel is 1154386506. It was assigned to this individual provider in the NPPES registry on April 19, 2006.

Where is Kalpesh Patel located?

Kalpesh Patel practices at 12624 S Route 59, Plainfield, IL 60585. The listed phone number is (815) 577-6446.

What is Kalpesh Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kalpesh Patel enrolled in Medicare?

Yes. Kalpesh Patel 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 Kalpesh Patel accept?

Health plans from UnitedHealthcare list Kalpesh Patel 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 Kalpesh Patel affiliated with any hospitals?

According to CMS data, Kalpesh Patel is affiliated with Presence Saint Joseph Medical Center, Copley Memorial Hospital and Edward Hospital.

When was this NPI record last updated?

The NPPES record for Kalpesh Patel was last updated on April 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.