DR. KRISHNA B PATEL MD
NPI 1477972412
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in Wheaton, IL

NPI Status: Active since April 07, 2014

Contact Information

2015 N MAIN ST
WHEATON, IL
ZIP 60187
Phone: (630) 668-8250
Fax: (630) 668-9561

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  • Individual
  • Female
  • Years of Experience 13
  • Ophthalmology
  • Ophthalmic Plastic and Reconstructive Su...
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About KRISHNA PATEL

This page provides the complete NPI Profile along with additional information for Krishna Patel, a provider established in Wheaton, Illinois with a medical specialization in Ophthalmology, focusing in ophthalmic plastic and reconstructive surgery and more than 13 years of experience. She graduated from University Of Missouri, Kansas City, School Of Medicine in 2014. The healthcare provider is registered in the NPI registry with number 1477972412 assigned on April 2014. The practitioner's primary taxonomy code is 207WX0200X with license number 036143831 (IL). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1477972412
Provider Name
DR. KRISHNA B PATEL MD
Gender
Female
Entity Type
Individual
Location Address
2015 N MAIN ST WHEATON, IL 60187
Location Phone
(630) 668-8250
Location Fax
(630) 668-9561
Mailing Address
2015 N MAIN ST WHEATON, IL 60187
Mailing Phone
(630) 668-8250
Mailing Fax
(630) 668-9561
Medical School Name
UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduation Year
2014
Is Sole Proprietor?
No
Enumeration Date
04-07-2014
Last Update Date
08-26-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Ophthalmology Ophthalmic Plastic and Reconstructive Surgery

Taxonomy Code
207WX0200X
Type
Allopathic & Osteopathic Physicians
License No.
036143831
License State
IL
Taxonomy Description
A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207W00000XAllopathic & Osteopathic Physicians

Ophthalmology

036143831 (IL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
036-143831MEDICAID (05)IL 

Medicare Participation & PECOS Enrollment Status

Krishna Patel is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Krishna Patel is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2466750229

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20201124003325

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient complete exam of visual system

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

This service was performed 23 times for 22 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 229 times for 202 patients

Established patient problem focused exam of visual system

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

This service was performed 435 times for 361 patients

Exam of visual field with extended testing

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

This service was performed 18 times for 15 patients

Exam of visual field with limited testing

An exam of the visual field with limited testing is a quick check of your peripheral vision. It involves identifying objects or movements at the edge of your sight, helping to detect any vision loss that isn't obvious, such as blind spots or areas of reduced vision.

This service was performed 19 times for 19 patients

Extensive repair of turning-outward eyelid defect

This procedure corrects an eyelid defect where the eyelid turns outward, exposing the eye. The extensive repair involves surgical techniques to reshape the eyelid and ensure it functions properly. This helps protect the eye and improve comfort.

This service was performed 21 times for 19 patients

Injection into skin growth, 1-7 growths

This procedure involves injecting medication into 1-7 skin growths. The medication helps to reduce the size of the growths or completely eliminate them. It's a simple, quick, and usually painless process performed by a medical professional.

This service was performed 34 times for 27 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 84 times for 27 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 patients

New patient complete exam of visual system

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

This service was performed 11 times for 11 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 42 times for 42 patients

New patient problem focused exam of visual system

A new patient problem-focused exam of the visual system is a basic evaluation of your eyes and vision. It includes checking your eye movements, visual acuity, and general eye health. It helps detect any potential issues early for timely treatment.

This service was performed 36 times for 36 patients

Photography of content of eyes

Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.

This service was performed 53 times for 52 patients

Probing of nasal tear duct

Probing of the nasal tear duct is a procedure to treat blocked tear ducts. A thin, flexible instrument is gently inserted into the tear duct to clear any obstruction, allowing tears to drain normally again. This procedure is typically quick and can help to alleviate symptoms like excessive tearing or infection.

This service was performed 27 times for 27 patients

Removal of chronic growth of eyelid

The removal of a chronic growth on the eyelid is a procedure performed to eliminate persistent, non-cancerous lumps. It involves a minor surgical process where the growth is carefully excised. This helps to improve eyelid function, comfort, and appearance.

This service was performed 19 times for 17 patients

Removal of excessive skin and fat of upper eyelid

This procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.

This service was performed 26 times for 26 patients

Removal of growth of eyelid

The removal of an eyelid growth is a procedure performed to eliminate abnormal tissue from your eyelid. It's generally a quick, outpatient treatment. The doctor numbs your eyelid, carefully removes the growth, and may stitch the area if necessary. This can help maintain eye health and vision.

This service was performed 14 times for 14 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less

This procedure involves the removal of a noncancerous skin growth on the face, ears, eyelids, nose, lips, or mouth that is 0.5 cm or less in size. It is a safe, routine treatment that helps maintain skin health and appearance.

This service was performed 14 times for 13 patients

Removal of skin tag, 1-15 skin tags

Skin tag removal is a simple procedure where small, benign growths on the skin are carefully removed. This can be achieved through several methods such as freezing, burning, or cutting off the skin tags. The process is quick, typically painless with local anesthesia, and aids in skin smoothness.

This service was performed 12 times for 12 patients

Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis

This procedure involves the removal of excess tissue, muscle, and membrane from the eyelid to correct drooping or paralysis. It helps improve vision and appearance. The operation is performed under local or general anesthesia, ensuring patient comfort throughout.

This service was performed 12 times for 12 patients

Repair of tendon of upper eyelid

Repair of the tendon of the upper eyelid is a surgical procedure aimed at fixing a droopy eyelid. This condition can affect your vision and appearance. The procedure involves tightening the tendon to lift the eyelid to its normal position, improving both function and aesthetics.

This service was performed 27 times for 27 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $34.35 for a new patient copayment and $18.59 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 60187 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $137.43
  • Minimum New Patient Price $59.81
  • Maximum New Patient Price $181.38
  • Average New Patient Copayment $34.35
  • Minimum New Patient Copayment $14.95
  • Maximum New Patient Copayment $45.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $74.38
  • Minimum Established Patient Price $19.15
  • Maximum Established Patient Price $147.12
  • Average Established Patient Copayment $18.59
  • Minimum Established Patient Copayment $4.78
  • Maximum Established Patient Copayment $36.78

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Krishna Patel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
RUSH UNIVERSITY MEDICAL CENTER1653 WEST CONGRESS PARKWAY
CHICAGO, IL 60612
(312) 942-5000Acute Care Hospitals
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL25 NORTH WINFIELD ROAD
WINFIELD, IL 60190
(630) 682-1600Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1477972412, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
7
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
7
Unchanged
Pos 7
2
Doubled → 4
Pos 8
4
Unchanged
Pos 9
1
Doubled → 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 9 → 18 → 9 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 4 + 7 + 1 + 8 + 7 + 4 + 4 + 2 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1477972412.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Optometrist
2015 N MAIN ST
WHEATON, IL 60187
Optometrist
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Optometrist
2015 N MAIN ST
WHEATON, IL 60187
Clinic/Center (Ambulatory Surgical)
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology (Retina Specialist)
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology (Pediatric Ophthalmology and Strabismus Specialist)
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology (Retina Specialist)
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology (Cornea and External Diseases Specialist)
2015 N MAIN ST
WHEATON, IL 60187

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477972412, enumerated as an "individual" on April 07, 2014.

The provider is located at 2015 N MAIN ST WHEATON, IL 60187 and the phone number is (630) 668-8250.

Ophthalmology with taxonomy code 207WX0200X and a focus in Ophthalmic Plastic and Reconstructive Surgery.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health,. Please consult your insurance carrier or call the provider to verify.

Krishna Patel is affiliated with: RUSH UNIVERSITY MEDICAL CENTER and NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL.