PRAYAG NAINESHKUMAR PATEL MD
NPI 1295175487
Family Medicine in Macomb, IL

Q: What is Prayag Patel's NPI number?

The NPI number for Prayag Patel is 1295175487. It was assigned to this individual provider in the NPPES registry on July 2, 2013.

Q: What is Prayag Patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Prayag Patel was last updated on June 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 July 02, 2013PECOS EnrolledAccepts Medicare Assignment

525 E GRANT ST, MACOMB, IL 61455(309) 833-4101 Get Directions Write a Review

NPPES record last updated: June 29, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Prayag Naineshkumar Patel Md NPPES

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

PRAYAG NAINESHKUMAR PATEL MD (NPI 1295175487) is an individual family medicine provider in Macomb, Illinois, licensed in Illinois (336100624) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1295175487

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePRAYAG NAINESHKUMAR PATELCredential: MD

Location Address525 E GRANT STMacomb, IL 61455-3313

Mailing Address525 E Grant StMacomb, IL 61455-3313 · (309) 833-4101

Phone(309) 833-4101

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateJuly 2, 2013

Last NPPES UpdateJune 29, 2016

✔ NPI 1295175487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 336100624

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

525 E GRANT ST, Macomb, IL 61455

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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

Prayag Naineshkumar Patel 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 ID5294025243

PECOS Enrollment IDI20160908003004

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 4

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 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.

226 services115 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.

176 services144 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

162 services143 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.

112 services76 patients

Hospital Affiliations CMS Care Compare 2

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140053

Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County

Emergency services Birthing friendly

Mc Donough District Hospital

Acute Care Hospitals · Macomb, IL

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number140089

Location525 East Grant StreetMacomb, IL 61455 · Mc Donough County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61455 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

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

3 suppliers17 claims17 services$110.73 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers21 claims21 services$35.40 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 20

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

MCDONOUGH COUNTY HOSPITAL DISTRICT

Emergency Medicine