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ARLINDA ELEZI MD
NPI 1295173466
Internal Medicine in Elmhurst, IL

Active since June 10, 2013PECOS EnrolledAccepts Medicare Assignment
91.35/100
CMS Quality Rating
429 N YORK ST, ELMHURST, IL 60126(331) 221-4350 Get Directions Write a Review

NPPES record last updated: July 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 27, 2022, Apr 22, 2021, Dec 12, 2016 (3 updates tracked since 2016).

About Arlinda Elezi Md NPPES

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

ARLINDA ELEZI MD (NPI 1295173466) is an individual internal medicine provider in Elmhurst, Illinois, licensed in Illinois (036133878) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS, is affiliated with Loyola Gottlieb Memorial Hospital, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1295173466
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameARLINDA ELEZICredential: MD
Location Address429 N YORK STElmhurst, IL 60126-2003
Mailing Address4201 Winfield Rd Fl 4Warrenville, IL 60555-4025 · (331) 221-6377 · Fax (331) 221-2357
Phone(331) 221-4350
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateJune 10, 2013
Last NPPES UpdateJuly 27, 20223 updates tracked since enumeration
NPPES CertifiedJuly 27, 2022
✔ NPI 1295173466 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 · 036133878
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.
429 N YORK ST, Elmhurst, IL 60126
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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

Arlinda Elezi 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 ID2769617695
PECOS Enrollment IDI20131031001529
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 17

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 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.
311 services55 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.
270 services182 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.
169 services133 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.
153 services153 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.
101 services36 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
64 services51 patients

Hospital Affiliations CMS Care Compare 3

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

Loyola Gottlieb Memorial Hospital

Acute Care Hospitals · Melrose Park, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140008
Location701 West North AveMelrose Park, IL 60160 · Cook County
Emergency services

Elmhurst Memorial Hospital

Acute Care Hospitals · Elmhurst, IL
4/5 CMS rating
OwnershipProprietary
CMS Certification Number140200
Location155 East Brush Hill RoadElmhurst, IL 60126 · Du Page 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 60126 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.

91.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.71
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

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
13 suppliers31 claims80 services$6.02 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers18 claims18 services$0.91 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 suppliers17 claims17 services$44.53 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
2 suppliers21 claims21 services$9.82 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
2 suppliers21 claims21 services$45.86 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers13 claims13 services$208.47 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 2

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

MARCELLA R LAFIDO CNS
Clinical Nurse Specialist (Medical-Surgical)
429 N YORK ST, ATTN RAYLENE BOYD
ELMHURST, IL 60126
Dupage County (630) 782-4050
NANCY SCHWABAUER CNS
Clinical Nurse Specialist (Acute Care)
429 N YORK ST
ELMHURST, IL 60126
Dupage County (630) 782-4050

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 Arlinda Elezi's NPI number?

The NPI number for Arlinda Elezi is 1295173466. It was assigned to this individual provider in the NPPES registry on June 10, 2013.

Where is Arlinda Elezi located?

Arlinda Elezi practices at 429 N York St, Elmhurst, IL 60126. The listed phone number is (331) 221-4350.

What is Arlinda Elezi's specialty?

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

Is Arlinda Elezi enrolled in Medicare?

Yes. Arlinda Elezi 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 Arlinda Elezi accept?

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

According to CMS data, Arlinda Elezi is affiliated with Loyola Gottlieb Memorial Hospital, Elmhurst Memorial Hospital and Edward Hospital.

When was this NPI record last updated?

The NPPES record for Arlinda Elezi was last updated on July 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.