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SHELDON M HIRSCH MD
NPI 1174509020
Internal Medicine - Nephrology in Chicago, IL

Active since December 21, 2005PECOS EnrolledAccepts Medicare Assignment
1717 S WABASH AVE, CHICAGO, IL 60616(312) 913-0110(312) 913-9154 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sheldon M Hirsch Md NPPES

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

SHELDON M HIRSCH MD (NPI 1174509020) is an individual nephrology provider in Chicago, Illinois, licensed in Illinois (036065928) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1174509020
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameSHELDON M HIRSCHCredential: MD
Location Address1717 S WABASH AVEChicago, IL 60616-1219
Mailing Address2277 W Howard StChicago, IL 60645-1922 · (773) 508-0110 · Fax (773) 508-0074
Phone(312) 913-0110
Fax(312) 913-9154
Sole ProprietorNo
Medical School CMSOtherGraduated 1981
Enumeration DateDecember 21, 2005
Last NPPES UpdateJuly 16, 2025
NPPES CertifiedJuly 16, 2025
✔ NPI 1174509020 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 · 036065928
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.
1717 S WABASH AVE, Chicago, IL 60616
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12277 W Howard StChicago, IL 60645-1922 · Phone (773) 508-0110 · Fax (773) 508-0074
Location 21101 S Canal StChicago, IL 60607-4901 · Phone (312) 986-0110 · Fax (312) 663-1010

Other Identifiers 2

Other01621679IL · Bcbs Of Il
Medicaid036065928IL

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

Sheldon M Hirsch 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 ID8729175427
PECOS Enrollment IDI20101222000451
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 10

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.

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.
379 services52 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.
156 services63 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.
129 services80 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.
100 services54 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.
58 services50 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.
50 services28 patients

Hospital Affiliations CMS Care Compare 4

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

Presence Saint Francis Hospital

Acute Care Hospitals · Evanston, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140080
Location355 Ridge AveEvanston, IL 60202 · Cook County
Emergency services

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

Rush University Medical Center

Acute Care Hospitals · Chicago, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140119
Location1653 West Congress ParkwayChicago, IL 60612 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60616 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.

Reported Quality Measures

Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
2%121 patients1/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
15%87 patients1/55-star benchmark: 98%
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.
64%6,800 patients1/55-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.
94%36 patients4/55-star benchmark: 100%
Patient-Generated Health Data
Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.
0%257 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
86%257 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
15%147 patients1/55-star benchmark: 90%
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…
48%257 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 74% · 166 patients
75%166 patients
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
93%189 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
2%257 patients1/55-star benchmark: 75%
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+: 0% · 147 patients
0%147 patients5/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
1%257 patients
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.

Other Providers at the Same Location NPPES 2

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

LAKESIDE NEPHROLGOY LTD/PRARIE
Specialist
1717 S WABASH AVE
CHICAGO, IL 60616
Cook County (312) 913-0110
DIALYSIS CENTERS OF AMERICA - ILLINOIS, INC.
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1717 S WABASH AVE
CHICAGO, IL 60616
Cook County (312) 913-0000

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 Sheldon Hirsch's NPI number?

The NPI number for Sheldon Hirsch is 1174509020. It was assigned to this individual provider in the NPPES registry on December 21, 2005.

Where is Sheldon Hirsch located?

Sheldon Hirsch practices at 1717 S Wabash Ave, Chicago, IL 60616. The listed phone number is (312) 913-0110.

What is Sheldon Hirsch's specialty?

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

Is Sheldon Hirsch enrolled in Medicare?

Yes. Sheldon Hirsch 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 Sheldon Hirsch accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Sheldon Hirsch 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 Sheldon Hirsch affiliated with any hospitals?

According to CMS data, Sheldon Hirsch is affiliated with Northshore University Healthsystem - Evanston Hospital, Presence Saint Francis Hospital, Swedish Hospital and Rush University Medical Center.

When was this NPI record last updated?

The NPPES record for Sheldon Hirsch was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.