NISHANT AGRAWAL
NPI 1265571061
Otolaryngology in Chicago, IL

Q: What is Nishant Agrawal's NPI number?

The NPI number for Nishant Agrawal is 1265571061. It was assigned to this individual provider in the NPPES registry on February 6, 2007.

Q: What is Nishant Agrawal's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Nishant Agrawal was last updated on November 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 06, 2007PECOS EnrolledAccepts Medicare Assignment

97.71/100

CMS Quality Rating

5841 S MARYLAND AVE, CHICAGO, IL 60637(888) 824-0200 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2025, Oct 24, 2022, May 19, 2022 and 2 more (5 updates tracked since 2019).

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About Nishant Agrawal NPPES

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

NISHANT AGRAWAL (NPI 1265571061) is an individual otolaryngology provider in Chicago, Illinois, licensed in Illinois (036138902) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and maintains a secondary practice location in Crown Point.

NPPES Registry Identity

NPI1265571061

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameNISHANT AGRAWAL

Location Address5841 S MARYLAND AVEChicago, IL 60637-1443

Mailing Address150 Harvester Dr, Suite 300Burr Ridge, IL 60527-5919

Phone(888) 824-0200

Sole ProprietorNo

Medical School CMSJohns Hopkins University School Of MedicineGraduated 2001

Enumeration DateFebruary 6, 2007

Last NPPES UpdateNovember 19, 20255 updates tracked since enumeration

NPPES CertifiedNovember 19, 2025

✔ NPI 1265571061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

Licenses✔ Licensed in IL · 036138902✔ Licensed in IN · 01084591A

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

5841 S MARYLAND AVE, Chicago, IL 60637

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Secondary Practice Location 1

Location 110855 Virginia StCrown Point, IN 46307-0210 · Phone (888) 824-0200

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

Nishant Agrawal 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 ID3072675289

PECOS Enrollment IDI20151109000696, I20251126003398

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 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.

201 services153 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

156 services107 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.

117 services102 patients

Diagnostic exam of voice box using a flexible endoscope 31575

51 services42 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

37 services34 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

31 services27 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

29 services24 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

23 services23 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.

23 services22 patients

Removal of less than half of tongue 41120

This procedure, known as a partial glossectomy, involves removing less than half of the tongue due to conditions like oral cancer. It aims to eliminate disease while preserving speech and swallowing functions as much as possible.

14 services13 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

13 services13 patients

Diagnostic exam of voice box using an endoscope 31525

This procedure involves the use of a thin, flexible instrument called an endoscope to examine the voice box. The endoscope is gently inserted through the nose or mouth to provide a clear view of the voice box. It helps in diagnosing issues related to speech, breathing, or swallowing.

12 services11 patients

Hospital Affiliations CMS Care Compare 2

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

The University Of Chicago Medical Center

Acute Care Hospitals · Chicago, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140088

Location5841 South MarylandChicago, IL 60637 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60637 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

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

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.

97.71/100

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

Scored through an Alternative Payment Model

Quality

75.43

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 4

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

Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each A7507

DME-Orthotic Devices · category DF000N

1 supplier12 claims2,010 services$2.41 avg. paid by Medicare

Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each A7520

DME-Orthotic Devices · category DF000N

2 suppliers11 claims11 services$41.74 avg. paid by Medicare

Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4036

Other-Enteral and Parenteral · category OB006N

2 suppliers16 claims388 services$3.71 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

2 suppliers18 claims10,593 services$0.26 avg. paid by Medicare

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

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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.

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