DR. RASHID AHMED DALAL MD
NPI 1265434815
Internal Medicine - Nephrology in Fairview Heights, IL

Q: What is Rashid Dalal's NPI number?

The NPI number for Rashid Dalal is 1265434815. It was assigned to this individual provider in the NPPES registry on August 12, 2005.

Q: What is Rashid Dalal'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 Rashid Dalal was last updated on April 30, 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 August 12, 2005PECOS Enrolled

75.47/100

CMS Quality Rating

5003 N ILLINOIS ST STE 1, FAIRVIEW HEIGHTS, IL 62208(618) 239-9500(618) 239-9555 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 30, 2024, Mar 8, 2021 (2 updates tracked since 2021).

On this page

About Dr. Rashid Ahmed Dalal Md NPPES

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

DR. RASHID AHMED DALAL MD (NPI 1265434815) is an individual nephrology provider in Fairview Heights, Illinois, licensed in Illinois (036090043) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Touchette Regional Hospital Inc, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1265434815

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. RASHID AHMED DALALCredential: MD

Location Address5003 N ILLINOIS ST STE 1Fairview Heights, IL 62208-3419

Mailing Address7 Beaver Creek CtSaint Charles, MO 63303-5497 · (618) 239-9500 · Fax (618) 239-9555

Phone(618) 239-9500

Fax(618) 239-9555

Sole ProprietorNo

Medical School CMSOtherGraduated 1985

Enumeration DateAugust 12, 2005

Last NPPES UpdateApril 30, 20242 updates tracked since enumeration

NPPES CertifiedApril 30, 2024

✔ NPI 1265434815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

Licenses✔ Licensed in IL · 036090043✔ Licensed in MO · MD103192

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.

5003 N ILLINOIS ST STE 1, Fairview Heights, IL 62208

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Other Identifiers 10

Other286639Healthlink Ppo Hmo Wc

Other8226186IL · Bcbs

Medicaid036090043IL

Other110184061Rr Medicare

Other110483Bcbs Choice

Medicaid203771902MO

Other38137Ghp Sensicare Access, Cmr

Other2369786Aetna Prudential

Other3100008 NEPHUnited Healthcare

Other816M2MO · Bcbs Alliance

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Medica and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Rashid Ahmed Dalal Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7315982691

PECOS Enrollment IDI20050627001179, I20111027000384

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.

Medicare Billing Reassignments

Medicare enrollment records show Rashid Dalal reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rashid A Dalal MD PC

Same address

Nephrology

5003 N ILLINOIS ST STE 1
Fairview Heights, IL 62208

Reassigned Medicare billing, Illinois and Missouri enrollments
5 clinicians in this Medicare group

NPI 1053390484 (618) 239-9500

Southern Illinois Healthcare Foundation, Inc.

1.1 mi

Federally Qualified Health Center (FQHC)

4969 BENCHMARK CENTRE DR STE 100
Swansea, IL 62226

Reassigned Medicare billing, Illinois enrollment
164 clinicians in this Medicare group

NPI 1063691897 (618) 235-2311

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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.

310 services113 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.

211 services65 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.

209 services68 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.

184 services69 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.

174 services93 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.

104 services91 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.

91 services65 patients

Dialysis services, 1 physician visit per month (20 years or older) 90962

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 canâ€™t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.

75 services36 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.

71 services61 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.

64 services12 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

59 services48 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Hospital Affiliations CMS Care Compare 5

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

Touchette Regional Hospital Inc

Acute Care Hospitals · Centreville, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number140077

Location5900 Bond AvenueCentreville, IL 62207 · St. Clair County

Emergency services

Gateway Regional Medical Center

Acute Care Hospitals · Granite City, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140125

Location2100 Madison AvenueGranite City, IL 62040 · Madison County

Emergency services

Memorial Hospital

Acute Care Hospitals · Belleville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140185

Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County

Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140187

LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County

Emergency services Birthing friendly

St Joseph's Hospital

Critical Access Hospitals · Highland, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number141336

Location12866 Troxler AvenueHighland, IL 62249 · Madison County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62208 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

$131.14 typical visit price

range $56.28 – $173.35

Typical copayment $32.78 (range $14.07 – $43.33)

Most-billed visit code 99204

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

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.

75.47/100

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

Individually scored

Quality

59.25

Improvement Activities

Cost

39.23

Reported Quality Measures

Breast Cancer Screening

57%30 patients3/55-star benchmark: 93%

Cervical Cancer Screening

45%31 patients2/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

0%83 patients1/55-star benchmark: 87%

Controlling High Blood Pressure

57%87 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

43%53 patients2/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

34%53 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

100%165 patients5/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%301 patients1/55-star benchmark: 100%

HIV Screening

59%76 patients4/55-star benchmark: 60%

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

89%106 patients4/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

82%76 patients4/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

23%118 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 98% · 105 patients

Patients screened: 98% · 105 patients

100%26 patients5/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

92%65 patients5/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 309 patients

Patients totalRate: 0% · 309 patients

0%309 patients5/55-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 3

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

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier11 claims1,980 services$0.33 avg. paid by Medicare

Mycophenolic acid, oral, 180 mg J7518

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier11 claims1,308 services$0.97 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

1 supplier12 claims12 services$12.64 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

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

RASHID A DALAL MD PC

Internal Medicine (Nephrology)

5003 N ILLINOIS ST STE 1
FAIRVIEW HEIGHTS, IL 62208

St. Clair County (618) 239-9500

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 Rashid Dalal's NPI number?

The NPI number for Rashid Dalal is 1265434815. It was assigned to this individual provider in the NPPES registry on August 12, 2005.

Where is Rashid Dalal located?

Rashid Dalal practices at 5003 N Illinois St Ste 1, Fairview Heights, IL 62208. The listed phone number is (618) 239-9500.

What is Rashid Dalal's specialty?

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

Is Rashid Dalal enrolled in Medicare?

Yes. Rashid Dalal is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Rashid Dalal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rashid Dalal reassigns Medicare benefits to 2 organizations: Rashid A Dalal MD PC (Fairview Heights, IL) and Southern Illinois Healthcare Foundation, Inc. (Swansea, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rashid Dalal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Rashid Dalal accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Medica and UnitedHealthcare list Rashid Dalal 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 Rashid Dalal affiliated with any hospitals?

According to CMS data, Rashid Dalal is affiliated with Touchette Regional Hospital Inc, Gateway Regional Medical Center, Memorial Hospital, Hshs St Elizabeth's Hospital and St Joseph's Hospital.

When was this NPI record last updated?

The NPPES record for Rashid Dalal was last updated on April 30, 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.