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DR. KRUNAL PATEL MD
NPI 1396127239
Internal Medicine in Addison, IL

Active since June 28, 2015PECOS EnrolledAccepts Medicare Assignment
91.35/100
CMS Quality Rating
303 W LAKE ST, SUITE 200, ADDISON, IL 60101(331) 221-9001 Get Directions Write a Review

NPPES record last updated: April 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 22, 2021, Oct 12, 2018 (2 updates tracked since 2018).

About Dr. Krunal Patel Md NPPES

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

DR. KRUNAL PATEL MD (NPI 1396127239) is an individual internal medicine provider in Addison, Illinois, licensed in Illinois (036147421) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Elmhurst Memorial Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1396127239
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. KRUNAL PATELCredential: MD
Location Address303 W LAKE ST, SUITE 200Addison, IL 60101
Mailing Address4201 Winfield Rd Fl 4Warrenville, IL 60555-4025 · (331) 221-6377 · Fax (331) 221-2357
Phone(331) 221-9001
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJune 28, 2015
Last NPPES UpdateApril 22, 20212 updates tracked since enumeration
NPPES CertifiedApril 22, 2021
✔ NPI 1396127239 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 · 036147421
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.
303 W LAKE ST, Addison, IL 60101
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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

Dr. Krunal 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 ID7719273895
PECOS Enrollment IDI20181105000091
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 7

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 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.
260 services124 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.
98 services98 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.
67 services63 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.
42 services32 patients
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402
An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.
15 services15 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

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

Advocate Good Samaritan Hospital

Acute Care Hospitals · Downers Grove, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140288
Location3815 Highland AvenueDowners Grove, IL 60515 · Du Page County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60101 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 3

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
5 suppliers13 claims40 services$6.40 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers23 claims23 services$27.31 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
4 suppliers16 claims1,020 services$0.10 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.

ELMHURST MEMORIAL HEALTHCARE
Internal Medicine
303 W LAKE ST, SUITE 202
ADDISON, IL 60101
Dupage County (630) 953-3301
DALE LIAUGMINAS, M.D. S.C.
Specialist
303 W LAKE ST, #201
ADDISON, IL 60101
Dupage County (630) 628-8450
JOHN SCHROEDER LPC, NBCC
Counselor (Professional)
303 W LAKE ST
ADDISON, IL 60101
Dupage County (630) 527-3200
AMY LEE APRN-FPA
Nurse Practitioner
303 W LAKE ST
ADDISON, IL 60101
Dupage County (331) 221-0570
RACHEL RAMIREZ PA-C
Physician Assistant
303 W LAKE ST
ADDISON, IL 60101
Dupage County (630) 527-3645
ISABELLA KISTULINEC PSYD
Psychologist (Clinical)
303 W LAKE ST
ADDISON, IL 60101
Dupage County (630) 527-3645
ELMHURST MEMORIAL AFFILIATED PRIMARY CARE PHYSICIANS, LLC
Clinic/Center
303 W LAKE ST, SUITE 206
ADDISON, IL 60101
Dupage County (630) 543-4200
DR. PETER T SCHUBEL M.D.
Emergency Medicine
303 W LAKE ST
ADDISON, IL 60101
Dupage County (630) 527-3645

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 Krunal Patel's NPI number?

The NPI number for Krunal Patel is 1396127239. It was assigned to this individual provider in the NPPES registry on June 28, 2015.

Where is Krunal Patel located?

Krunal Patel practices at 303 W Lake St Suite 200, Addison, IL 60101. The listed phone number is (331) 221-9001.

What is Krunal Patel's specialty?

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

Is Krunal Patel enrolled in Medicare?

Yes. Krunal 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.

What insurance does Krunal Patel accept?

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

According to CMS data, Krunal Patel is affiliated with Elmhurst Memorial Hospital and Advocate Good Samaritan Hospital.

When was this NPI record last updated?

The NPPES record for Krunal Patel was last updated on April 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.