SANJAY PRASAD M.D.
NPI 1437232139
Otolaryngology in Rockford, IL
About Sanjay Prasad M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SANJAY PRASAD M.D. (NPI 1437232139) is an individual otolaryngology provider in Rockford, Illinois, licensed in Illinois (036176815) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and maintains a secondary practice location in Bethesda.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Location 1
Accepted 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
Sanjay Prasad 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.
Medicare Billing Reassignments
8Medicare enrollment records show Sanjay Prasad reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Rockford, IL 61107
- Reassigned Medicare billing, Illinois enrollment
- 474 clinicians in this Medicare group
Peoria, IL 61615
- Reassigned Medicare billing, Illinois enrollment
- 2,944 clinicians in this Medicare group
Amherst, WI 54406
- Reassigned Medicare billing, Wisconsin enrollment
- 935 clinicians in this Medicare group
Stevens Point, WI 54481
- Reassigned Medicare billing, Wisconsin enrollment
- 619 clinicians in this Medicare group
Ligonier, PA 15658
- Reassigned Medicare billing, Pennsylvania enrollment
- 771 clinicians in this Medicare group
Rockville, MD 20850
- Reassigned Medicare billing, District of Columbia and Maryland enrollments
- 3 clinicians in this Medicare group
Richmond, VA 23227
- Reassigned Medicare billing, Virginia enrollment
- 581 clinicians in this Medicare group
Miles City, MT 59301
- Reassigned Medicare billing, Montana enrollment
- 1,264 clinicians in this Medicare group
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 14
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.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Mary Medical Center
Acute Care Hospitals · Galesburg, ILSaint Francis Medical Center
Acute Care Hospitals · Peoria, ILUw Health
Acute Care Hospitals · Rockford, ILSidney Health Center
Critical Access Hospitals · Sidney, MTAspirus Rhinelander Hospital
Acute Care Hospitals · Rhinelander, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 61107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
ROCKFORD, IL 61107
ROCKFORD, IL 61107
ROCKFORD, IL 61107
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 Sanjay Prasad's NPI number?
The NPI number for Sanjay Prasad is 1437232139. It was assigned to this individual provider in the NPPES registry on October 24, 2006.
Where is Sanjay Prasad located?
Sanjay Prasad practices at 1253 N Alpine Rd, Rockford, IL 61107. The listed phone number is (779) 696-9201.
What is Sanjay Prasad's specialty?
The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.
Is Sanjay Prasad enrolled in Medicare?
Yes. Sanjay Prasad 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 Sanjay Prasad's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sanjay Prasad reassigns Medicare benefits to 8 organizations: Swedishamerican Hospital (Rockford, IL), Osf Multi-Specialty Group (Peoria, IL), Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. (Amherst, WI), Aspirus Stevens Point Hospital & Clinics, Inc. (Stevens Point, WI), Dlp Conemaugh Physician Practices LLC (Ligonier, PA) and 3 more organizations, listed in the Medicare section above. 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 Sanjay Prasad's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sanjay Prasad accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Anthem Blue Cross and Blue Shield and Aspirus Health Plan and 2 other insurers list Sanjay Prasad 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 Sanjay Prasad affiliated with any hospitals?
According to CMS data, Sanjay Prasad is affiliated with St Mary Medical Center, Saint Francis Medical Center, Uw Health, Sidney Health Center and Aspirus Rhinelander Hospital.
When was this NPI record last updated?
The NPPES record for Sanjay Prasad was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Sanjay Prasad, M.D. · NPI 1437232139
Otolaryngology physician in Rockford, Illinois. Individual provider, active in the CMS NPPES registry since October 24, 2006.
## Identity
- **NPI:** 1437232139 (Entity type: Individual)
- **Enumerated:** October 24, 2006
- **Primary specialty:** Otolaryngology · taxonomy 207Y00000X
- **State license:** 036176815 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1253 N ALPINE RD, Rockford, IL 61107-2201
- **Phone:** (779) 696-9201 · **Fax:** (815) 397-9667
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 8 organizations under Medicare reassignment (form CMS-855R): Swedishamerican Hospital (NPI 1144382268, Rockford, IL); Osf Multi-Specialty Group (NPI 1154908929, Peoria, IL); Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. (NPI 1316616428, Amherst, WI); Aspirus Stevens Point Hospital & Clinics, Inc. (NPI 1184082745, Stevens Point, WI); Dlp Conemaugh Physician Practices LLC (NPI 1588070551, Ligonier, PA); and 3 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Maryland School Of Medicine, class of 1985
## Record status
- **NPPES last updated:** March 23, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1437232139) · Data from the CMS NPPES public registry.