SANJAY PRASAD M.D.
NPI 1437232139
Otolaryngology in Rockford, IL

Active since October 24, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1253 N ALPINE RD, ROCKFORD, IL 61107(779) 696-9201(815) 397-9667 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 23, 2026, Dec 23, 2025 (2 updates tracked since 2025).

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 Uw Health, and maintains a secondary practice location in Bethesda.

NPPES Registry Identity

NPI1437232139
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameSANJAY PRASADCredential: M.D.
Location Address1253 N ALPINE RDRockford, IL 61107-2201
Mailing Address10215 Fernwood Rd, Suite 301Bethesda, MD 20817-1106 · (301) 493-9409 · Fax (301) 493-9429
Fax(815) 397-9667
Sole ProprietorYes
Medical School CMSUniversity Of Maryland School Of MedicineGraduated 1985
Enumeration DateOctober 24, 2006
Last NPPES UpdateMarch 23, 20262 updates tracked since enumeration
NPPES CertifiedMarch 23, 2026
NPI 1437232139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in IL · 036176815
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Also ListedOtolaryngology · Plastic Surgery within the Head & NeckTaxonomy 207YX0007X · License 036176815 (IL)
Also ListedOtolaryngology · Otology & NeurotologyTaxonomy 207YX0901X · License D43688 (MD)
1253 N ALPINE RD, Rockford, IL 61107

Secondary Practice Location 1

Location 110215 Fernwood Rd, Suite 301Bethesda, MD 20817-1106 · Phone (301) 493-9409 · Fax (301) 493-9429

Accepted 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

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.

PECOS PAC ID9931282902
PECOS Enrollment IDI20080213000749, I20170104000844, I20250512003168, I20251103001653, I20251125002328, I20260219000721, I20260605003897
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 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.

Test for allergy using allergenic extract 95004
An allergy test with allergenic extract is a diagnostic method to identify substances causing allergic reactions. Small amounts of common allergens are introduced to your body, usually through skin pricks or blood tests. Your body's response helps determine your allergies.
2,594 services34 patients
Professional service for preparation and provision of 1 or more antigens 95165
This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.
1,740 services17 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.
394 services186 patients
Exam of ear using a microscope 92504
An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.
293 services155 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
252 services134 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
227 services141 patients

Hospital Affiliations CMS Care Compare 5

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

Uw Health

Acute Care Hospitals · Rockford, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140228
Location1401 East State StreetRockford, IL 61104 · Winnebago County
Emergency services Birthing friendly

Billings Clinic

Acute Care Hospitals · Billings, MT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270004
Location2800 10th Ave NBillings, MT 59101 · Yellowstone County
Emergency services Birthing friendly

Sidney Health Center

Critical Access Hospitals · Sidney, MT
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number271344
Location216 14th Ave SWSidney, MT 59270 · Richland County
Emergency services Birthing friendly

Aspirus Rhinelander Hospital

Acute Care Hospitals · Rhinelander, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520019
Location2251 North Shore DrRhinelander, WI 54501 · Oneida County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician 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.

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
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

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.

Internal Medicine (Endocrinology, Diabetes & Metabolism)
1253 N ALPINE RD
ROCKFORD, IL 61107
Physician Assistant
1253 N ALPINE RD
ROCKFORD, IL 61107
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1253 N ALPINE RD
ROCKFORD, IL 61107
Nurse Practitioner (Family)
1253 N ALPINE RD
ROCKFORD, IL 61107
Audiologist
1253 N ALPINE RD
ROCKFORD, IL 61107
Audiologist
1253 N ALPINE RD
ROCKFORD, IL 61107
Otolaryngology
1253 N ALPINE RD
ROCKFORD, IL 61107
Otolaryngology (Plastic Surgery within the Head & Neck)
1253 N ALPINE RD
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.

What insurance does Sanjay Prasad accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, Providence Health Plan and Sanford Health Plan 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 Uw Health, Billings Clinic, Sidney Health Center, Aspirus Rhinelander Hospital and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Sanjay Prasad was last updated on March 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.