SHAAN SETIA MD
NPI 1427410182
Urology in Oak Brook, IL

Q: What is Shaan Setia's NPI number?

The NPI number for Shaan Setia is 1427410182. It was assigned to this individual provider in the NPPES registry on March 22, 2016.

Q: What is Shaan Setia's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Shaan Setia was last updated on October 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since March 22, 2016PECOS EnrolledAccepts Medicare Assignment

97.12/100

CMS Quality Rating

2011 YORK RD STE 2000A, OAK BROOK, IL 60523(630) 724-1300 Get Directions Write a Review

NPPES record last updated: October 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 8, 2024, May 12, 2021, May 5, 2021 and 2 more (5 updates tracked since 2016).

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About Shaan Setia Md NPPES

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

SHAAN SETIA MD (NPI 1427410182) is an individual urology provider in Oak Brook, Illinois, licensed in Illinois (036165000) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS, is affiliated with Copley Memorial Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1427410182

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameSHAAN SETIACredential: MD

Location Address2011 YORK RD STE 2000AOak Brook, IL 60523-2156

Mailing Address3841 Green Hills Village Dr Ste 200Nashville, TN 37215-2691 · (615) 936-2000

Phone(630) 724-1300

Sole ProprietorNo

Medical School CMSUniversity Of Virginia School Of MedicineGraduated 2016

Enumeration DateMarch 22, 2016

Last NPPES UpdateOctober 8, 20245 updates tracked since enumeration

NPPES CertifiedOctober 8, 2024

✔ NPI 1427410182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

Licenses✔ Licensed in IL · 036165000✔ Licensed in TN · PENDING

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

2011 YORK RD STE 2000A, Oak Brook, IL 60523

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Secondary Practice Locations 2

Location 11750 W Harrison St, suite 785Chicago, IL 60612-3825 · Phone (312) 942-6510

Location 23601 The Vanderbilt ClinicNashville, TN 37232-3825 · Phone (615) 322-3000

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

Shaan Setia 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 ID6305138033

PECOS Enrollment IDI20230911002771

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 15

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.

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

133 services103 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

127 services89 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.

105 services80 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.

76 services60 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.

59 services59 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

38 services35 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

36 services29 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

33 services32 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

29 services24 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

23 services18 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

21 services20 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

20 services20 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.

17 services16 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

16 services15 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Copley Memorial Hospital

Acute Care Hospitals · Aurora, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140029

Location2000 Ogden AvenueAurora, IL 60504 · Kane County

Emergency services Birthing friendly

Rush Oak Park Hospital

Acute Care Hospitals · Oak Park, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140063

Location520 S Maple AveOak Park, IL 60304 · Cook County

Emergency services

Rush University Medical Center

Acute Care Hospitals · Chicago, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140119

Location1653 West Congress ParkwayChicago, IL 60612 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60523 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

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

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.

97.12/100

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

Scored through an Alternative Payment Model

Quality

85.64

Promoting Interoperability

100

Improvement Activities

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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 Shaan Setia's NPI number?

The NPI number for Shaan Setia is 1427410182. It was assigned to this individual provider in the NPPES registry on March 22, 2016.

Where is Shaan Setia located?

Shaan Setia practices at 2011 York Rd Ste 2000A, Oak Brook, IL 60523. The listed phone number is (630) 724-1300.

What is Shaan Setia's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Shaan Setia enrolled in Medicare?

Yes. Shaan Setia 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 Shaan Setia accept?

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

According to CMS data, Shaan Setia is affiliated with Copley Memorial Hospital, Rush Oak Park Hospital and Rush University Medical Center.

When was this NPI record last updated?

The NPPES record for Shaan Setia was last updated on October 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.