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DR. PARAGKUMAR C PATEL M.D.
NPI 1316288517
Internal Medicine - Critical Care Medicine in Springfield, IL

Active since March 13, 2013PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
800 E CARPENTER ST, SPRINGFIELD, IL 62769(217) 544-6464(214) 525-5673 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 15, 2025, Nov 24, 2025, Dec 13, 2023 and 4 more (7 updates tracked since 2015).

About Dr. Paragkumar C Patel M.d. NPPES

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

DR. PARAGKUMAR C PATEL M.D. (NPI 1316288517) is an individual critical care medicine provider in Springfield, Illinois, licensed in Illinois (036167182) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - St Louis, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1316288517
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameDR. PARAGKUMAR C PATELCredential: M.D.
Location Address800 E CARPENTER STSpringfield, IL 62769-3413
Mailing Address800 E Carpenter StSpringfield, IL 62769-5556 · (217) 544-6464 · Fax (214) 525-5673
Phone(217) 544-6464
Fax(214) 525-5673
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateMarch 13, 2013
Last NPPES UpdateDecember 15, 20257 updates tracked since enumeration
NPPES CertifiedDecember 15, 2025
✔ NPI 1316288517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in IL · 036167182
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal MedicineTaxonomy 207R00000X · License 2020036098 (MO), 32065 (OK), 036167182 (IL)
800 E CARPENTER ST, Springfield, IL 62769
Open in Google Maps ↗

Secondary Practice Locations 2

Location 14401 S Western AveOklahoma City, OK 73109-3413 · Phone (405) 713-7403 · Fax (405) 713-2794
Location 21800 E Lake Shore DrDecatur, IL 62521-3810 · Phone (217) 464-5811

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CommunityCare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Paragkumar C Patel M.d. 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 ID1557662111
PECOS Enrollment IDI20210817001209
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

5

Medicare enrollment records show Paragkumar Patel reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cep America Illinois Intensivists
Same address
Critical Care Medicine
800 E CARPENTER ST
Springfield, IL 62769
  • Reassigned Medicare billing, Illinois enrollment
  • 99 clinicians in this Medicare group
NPI 1013784586 (217) 544-6464
Ssm Health Care Group
88 mi
Internal Medicine
1225 SOUTH GRAND BLVD, 2L - DOOR 3,4
Saint Louis, MO 63104
  • Reassigned Medicare billing, Missouri enrollment
  • 1,294 clinicians in this Medicare group
NPI 1306589544 (314) 977-6100
Physician Services Corporation Of Southern Illinois Inc.
109 mi
Internal Medicine
4218 LINCOLNSHIRE DR
Mount Vernon, IL 62864
  • Reassigned Medicare billing, Illinois enrollment
  • 296 clinicians in this Medicare group
NPI 1831101807 (618) 899-3600
Cole Physician Services LLC
160 mi
Hospitalist
100 ST. MARY'S MEDICAL PLAZA
Jefferson City, MO 65101
  • Reassigned Medicare billing, Missouri enrollment
  • 93 clinicians in this Medicare group
NPI 1144578659 (573) 761-7011
Lester E Cox Medical Centers
217 mi
Family Medicine
510 HIGHWAY 32
Lebanon, MO 65536
  • Reassigned Medicare billing, Missouri enrollment
  • 457 clinicians in this Medicare group
NPI 1326213232 (417) 269-2278

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 2

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
105 services64 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.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Ssm Health St Mary's Hospital - St Louis

Acute Care Hospitals · Richmond Heights, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260091
Location6420 Clayton RdRichmond Heights, MO 63117 · St. Louis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62769 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
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.

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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

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.

SANDRA SCROGGINS MD
Radiology (Diagnostic Radiology)
800 E CARPENTER ST
SPRINGFIELD, IL 62769
Sangamon County (217) 814-5178
STEPHANIE WEITEKAMP
Nurse Anesthetist, Certified Registered
800 E CARPENTER ST
SPRINGFIELD, IL 62769
Sangamon County (217) 544-6464
CEP AMERICA ILLINOIS INTENSIVISTS
Internal Medicine (Critical Care Medicine)
800 E CARPENTER ST
SPRINGFIELD, IL 62769
Sangamon County (217) 544-6464
DR. TERENCE EDWARD WADE M.D.
Radiology (Diagnostic Radiology)
800 E CARPENTER ST
SPRINGFIELD, IL 62769
Sangamon County (217) 544-6464
CASSI BRIELLE GROTEPAS M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
800 E CARPENTER ST
SPRINGFIELD, IL 62769
Sangamon County (217) 522-3117
DEEPAK AGARWAL M.D.
Anesthesiology
800 E CARPENTER ST
SPRINGFIELD, IL 62769
Sangamon County (217) 544-6464
DR. ONSI W KAMEL M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
800 E CARPENTER ST
SPRINGFIELD, IL 62769
Sangamon County (217) 544-6464
MISS ASHLEY NICOLE TILL OTR/L
Occupational Therapist
800 E CARPENTER ST
SPRINGFIELD, IL 62769
Sangamon County (217) 544-6464

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 Paragkumar Patel's NPI number?

The NPI number for Paragkumar Patel is 1316288517. It was assigned to this individual provider in the NPPES registry on March 13, 2013.

Where is Paragkumar Patel located?

Paragkumar Patel practices at 800 E Carpenter St, Springfield, IL 62769. The listed phone number is (217) 544-6464.

What is Paragkumar Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Paragkumar Patel enrolled in Medicare?

Yes. Paragkumar Patel 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.

Which organizations bill Medicare for Paragkumar Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paragkumar Patel reassigns Medicare benefits to 5 organizations: Cep America Illinois Intensivists (Springfield, IL), Ssm Health Care Group (Saint Louis, MO), Physician Services Corporation Of Southern Illinois Inc. (Mount Vernon, IL), Cole Physician Services LLC (Jefferson City, MO) and Lester E Cox Medical Centers (Lebanon, MO). 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 Paragkumar Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paragkumar Patel accept?

Health plans from Anthem Blue Cross and Blue Shield and CommunityCare list Paragkumar Patel 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 Paragkumar Patel affiliated with any hospitals?

According to CMS data, Paragkumar Patel is affiliated with Ssm Health St Mary's Hospital - St Louis.

When was this NPI record last updated?

The NPPES record for Paragkumar Patel was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.