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DR. WAEL GHALI M.D.
NPI 1467518118
Hospitalist in Evanston, IL

Active since December 28, 2006PECOS EnrolledAccepts Medicare Assignment
93.71/100
CMS Quality Rating
2650 RIDGE AVE, EVANSTON, IL 60201(847) 570-1010 Get Directions Write a Review

NPPES record last updated: April 12, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 12, 2024, Mar 7, 2023 (2 updates tracked since 2023).

About Dr. Wael Ghali M.d. NPPES

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

DR. WAEL GHALI M.D. (NPI 1467518118) is an individual hospitalist provider in Evanston, Illinois, licensed in Connecticut (041702) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Robert Wood Johnson University Hospital, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1467518118
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameDR. WAEL GHALICredential: M.D.
Location Address2650 RIDGE AVEEvanston, IL 60201-1718
Mailing Address2650 Ridge AveEvanston, IL 60201-1718 · (847) 570-1010
Phone(847) 570-1010
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateDecember 28, 2006
Last NPPES UpdateApril 12, 20242 updates tracked since enumeration
NPPES CertifiedApril 12, 2024
✔ NPI 1467518118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in CT · 041702
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 25MA08175700 (NJ)
2650 RIDGE AVE, Evanston, IL 60201
Open in Google Maps ↗

Other Identifiers 3

Other33840CT · Ct Csr
Medicaid001417022IL
Other041702CT · Ct Physician License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.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. Wael Ghali 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 ID1759283575
PECOS Enrollment IDI20110810000353
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 Wael Ghali reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rwjbh Emergency Medicine Associates, LLC
692 mi
Emergency Medicine
3 EXECUTIVE DR, STE 400
Somerset, NJ 08873
  • Reassigned Medicare billing, New Jersey enrollment
  • 1,557 clinicians in this Medicare group
NPI 1912510041 (732) 867-9618
Barnabas Health Medical Group PC
706 mi
Specialist
225 WILLIAMSON ST
Elizabeth, NJ 07202
  • Reassigned Medicare billing, New Jersey enrollment
  • 1,894 clinicians in this Medicare group
NPI 1841557246 (888) 724-7123
Mvp Medical Associates, PA
720 mi
Urgent Care
200 WYCKOFF ROAD
Eatontown, NJ 07724
  • Reassigned Medicare billing, New Jersey enrollment
  • 18 clinicians in this Medicare group
NPI 1992463384 (732) 531-0100
Mvp Medical Associates II LLC
722 mi
Urgent Care
1803 HIGHWAY 35
Oakhurst, NJ 07755
  • Reassigned Medicare billing, New Jersey enrollment
  • 21 clinicians in this Medicare group
NPI 1750164653 (732) 531-0100
Monmouth Family Health Center Inc
723 mi
Federally Qualified Health Center (FQHC)
335 BROADWAY
Long Branch, NJ 07740
  • Reassigned Medicare billing, New Jersey enrollment
  • 37 clinicians in this Medicare group
NPI 1962841502 (732) 923-7100

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 6

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.

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.
478 services227 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
222 services213 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
182 services170 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
175 services124 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.
78 services76 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
47 services44 patients

Hospital Affiliations CMS Care Compare 2

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

Robert Wood Johnson University Hospital

Acute Care Hospitals · New Brunswick, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310038
LocationOne Robert Wood Johnson PlaceNew Brunswick, NJ 08901 · Middlesex County
Emergency services Birthing friendly

Monmouth Medical Center

Acute Care Hospitals · Long Branch, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310075
Location300 Second AvenueLong Branch, NJ 07740 · Monmouth County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60201 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

93.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.79
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
92%209 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, heavy duty, wheeled, rigid or folding, any type E0149
DME-Other DME · category DE000N
1 supplier13 claims13 services$6.23 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
1 supplier11 claims11 services$41.99 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers68 claims75 services$60.07 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers40 claims47 services$29.35 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$30.72 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.

DR. THOMAS LEE CIBULL M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
2650 RIDGE AVE, EVANSTON HOSPITAL
EVANSTON, IL 60201
Cook County (847) 570-2040
LAUREN ANDERSON MD
Hospitalist
2650 RIDGE AVE
EVANSTON, IL 60201
Cook County (847) 570-1027
DR. DANIEL K. WEST MD
Radiology (Diagnostic Radiology)
2650 RIDGE AVE, DEPARTMENT OF RADIOLOGY, G507
EVANSTON, IL 60201
Cook County (847) 570-2475
JOEL BERNSTEIN M.D.
Radiology (Diagnostic Radiology)
2650 RIDGE AVE, EVANSTON HOSPITAL
EVANSTON, IL 60201
Cook County (847) 570-1206
MATTHEW R. SHERWOOD MD
Internal Medicine
2650 RIDGE AVE, DIVISION OF INTERNAL MEDICINE RM 4324
EVANSTON, IL 60201
Cook County (847) 570-1010
MICHAEL T. GILLAM M.D.
Emergency Medicine
2650 RIDGE AVE, EMERGENCY MEDICINE RM G909
EVANSTON, IL 60201
Cook County (847) 570-2114
MARLENE ANGELICO CNP
Nurse Practitioner (Acute Care)
2650 RIDGE AVE, EMERGENCY MEDICINE, RM G903C
EVANSTON, IL 60201
Cook County (847) 570-1355
MINA KEROLOS MD
Hospitalist
2650 RIDGE AVE
EVANSTON, IL 60201
Cook County (847) 570-1010

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 Wael Ghali's NPI number?

The NPI number for Wael Ghali is 1467518118. It was assigned to this individual provider in the NPPES registry on December 28, 2006.

Where is Wael Ghali located?

Wael Ghali practices at 2650 Ridge Ave, Evanston, IL 60201. The listed phone number is (847) 570-1010.

What is Wael Ghali's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Wael Ghali enrolled in Medicare?

Yes. Wael Ghali 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 Wael Ghali's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Wael Ghali reassigns Medicare benefits to 5 organizations: Rwjbh Emergency Medicine Associates, LLC (Somerset, NJ), Barnabas Health Medical Group PC (Elizabeth, NJ), Mvp Medical Associates, PA (Eatontown, NJ), Mvp Medical Associates II LLC (Oakhurst, NJ) and Monmouth Family Health Center Inc (Long Branch, NJ). 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 Wael Ghali's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Wael Ghali accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Wael Ghali 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 Wael Ghali affiliated with any hospitals?

According to CMS data, Wael Ghali is affiliated with Robert Wood Johnson University Hospital and Monmouth Medical Center.

When was this NPI record last updated?

The NPPES record for Wael Ghali was last updated on April 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.