SEJALBEN PATEL
NPI 1629528443
Nurse Practitioner - Primary Care in Chicago, IL

NPI Status: Active since October 04, 2016

Contact Information

6201 W TOUHY AVE
CHICAGO, IL
ZIP 60646
Phone: (630) 915-1874

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  • Individual
  • Female
  • Years of Experience 11
  • Nurse Practitioner
  • Primary Care
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SEJALBEN PATEL

This page provides the complete NPI Profile along with additional information for Sejalben Patel, a provider established in Chicago, Illinois with a medical specialization in Nurse Practitioner, focusing in primary care and more than 11 years of experience. The healthcare provider is registered in the NPI registry with number 1629528443 assigned on October 2016. The practitioner's primary taxonomy code is 363LP2300X with license number 209013921 (IL). The provider is registered as an individual and her NPI record was last updated 10 years ago.

NPI
1629528443
Provider Name
SEJALBEN PATEL
Gender
Female
Entity Type
Individual
Location Address
6201 W TOUHY AVE CHICAGO, IL 60646
Location Phone
(630) 915-1874
Mailing Address
6201 W TOUHY AVE CHICAGO, IL 60646
Medical School Name
OTHER
Graduation Year
2015
Is Sole Proprietor?
Yes
Enumeration Date
10-04-2016
Last Update Date
10-04-2016
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A nurse practitioner (NP) like Sejalben Patel is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

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

Nurse Practitioner Primary Care

Taxonomy Code
363LP2300X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
209013921
License State
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

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

Medicare Participation & PECOS Enrollment Status

Sejalben 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.

Sejalben 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: 4284914078

    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: I20161214000359

    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.

Adm sarscov2 100mcg/0.5ml3rd

This is the administration of a third dose of a SARS-CoV-2 vaccine, given in a dose of 100 micrograms in 0.5 milliliters. This vaccine helps your body develop immunity against the COVID-19 virus. It's a crucial step in protecting your health.

This service was performed 64 times for 64 patients

Adm sarscov2 30mcg/0.3ml 3rd

This refers to the administration of a 30 microgram dose of a SARS-CoV-2 vaccine in a 0.3 milliliter volume. It's the third dose, often referred to as a booster shot, which helps to strengthen your body's immune response against the COVID-19 virus.

This service was performed 85 times for 85 patients

Adm sarscov2 30mcg/0.3ml bst

This is an administration of a COVID-19 vaccine, specifically 30 micrograms in a 0.3 milliliter dosage. The vaccine helps your body build protection against the SARS-CoV-2 virus, which causes COVID-19.

This service was performed 62 times for 62 patients

Adm sarscov2 50mcg/0.25mlbst

This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.

This service was performed 17 times for 17 patients

Follow-up nursing facility visit per day, typically 25 minutes

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

This service was performed 83 times for 58 patients

Initial nursing facility visit per day, typically 45 minutes

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

This service was performed 47 times for 46 patients

Injection, sotrovimab, 500 mg

Sotrovimab is a 500 mg injection used to treat mild to moderate COVID-19 in individuals who are at high risk for progressing to severe disease. It's an artificial antibody that helps your body fight off the virus. It's given as a single dose.

This service was performed 30 times for 30 patients

Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose

This is your second dose of the COVID-19 vaccine, which is given via a shot into your muscle. The vaccine contains a tiny piece of the coronavirus's spike protein, which helps your body recognize and fight the virus. It's preservative-free and contains 100 mcg in a 0.5ml dose.

This service was performed 13 times for 13 patients

Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; first dose

This is your first dose of a COVID-19 vaccine. It's a shot given in the muscle, usually the arm. The vaccine uses mRNA technology to help your body recognize and fight the virus. It's preservative free and contains 30 mcg in a 0.3ml dose.

This service was performed 14 times for 14 patients

Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; second dose

This is your second dose of the COVID-19 vaccine, made to protect against severe acute respiratory syndrome coronavirus 2. It's a 30 mcg/0.3ml dose, preservative-free. The vaccine uses mRNA technology to stimulate your immune response. It's injected into a muscle, usually in the arm.

This service was performed 14 times for 14 patients

Intravenous infusion, sotrovimab, includes infusion and post administration monitoring

Intravenous infusion of sotrovimab involves injecting this medication through a vein, usually in your arm. The procedure includes careful monitoring during and after the infusion to ensure your body responds well to the treatment, and to manage any potential side effects.

This service was performed 30 times for 30 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $23.51 for a new patient copayment and $26.42 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 60646 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $94.06
  • Minimum New Patient Price $60.08
  • Maximum New Patient Price $183.39
  • Average New Patient Copayment $23.51
  • Minimum New Patient Copayment $15.02
  • Maximum New Patient Copayment $45.84

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $105.7
  • Minimum Established Patient Price $18.97
  • Maximum Established Patient Price $148.12
  • Average Established Patient Copayment $26.42
  • Minimum Established Patient Copayment $4.74
  • Maximum Established Patient Copayment $37.03

* 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.

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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 1629528443, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

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
6
Unchanged
Pos 3
2
Doubled → 4
Pos 4
9
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
2
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
4
Unchanged
Pos 9
4
Doubled → 8
Check
3
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 2 → 4 5 → 10 → 1 8 → 16 → 7 4 → 8

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 4 + 9 + 1 + 0 + 2 + 1 + 6 + 4 + 8 + 24 = 67

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

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1629528443.

Other Providers at the Same Location


The following 17 providers are registered at the same or a nearby location.

Podiatrist (Foot & Ankle Surgery)
6201 W TOUHY AVE
CHICAGO, IL 60646
Physical Therapist
6201 W TOUHY AVE
CHICAGO, IL 60646
Pharmacist
6201 W TOUHY AVE, SUITE 101
CHICAGO, IL 60646
Pharmacy (Community/Retail Pharmacy)
6201 W TOUHY AVE, SUITE 101
CHICAGO, IL 60646
Family Medicine
6201 W TOUHY AVE
CHICAGO, IL 60646
Family Medicine
6201 W TOUHY AVE
CHICAGO, IL 60646
Family Medicine
6201 W TOUHY AVE
CHICAGO, IL 60646
Nurse Practitioner
6201 W TOUHY AVE
CHICAGO, IL 60646
Nurse Practitioner
6201 W TOUHY AVE
CHICAGO, IL 60646
Podiatrist (Foot & Ankle Surgery)
6201 W TOUHY AVE
CHICAGO, IL 60646
Nurse Practitioner (Gerontology)
6201 W TOUHY AVE
CHICAGO, IL 60646
Nurse Practitioner (Family)
6201 W TOUHY AVE
CHICAGO, IL 60646
Nurse Practitioner (Family)
6201 W TOUHY AVE
CHICAGO, IL 60646
Physical Therapist
6201 W TOUHY AVE
CHICAGO, IL 60646
Custodial Care Facility (Adult Care Home)
6201 W TOUHY AVE
CHICAGO, IL 60646
Family Medicine
6201 W TOUHY AVE
CHICAGO, IL 60646
Nurse Practitioner (Family)
6201 W TOUHY AVE
CHICAGO, IL 60646

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629528443, enumerated as an "individual" on October 04, 2016.

The provider is located at 6201 W TOUHY AVE CHICAGO, IL 60646 and the phone number is (630) 915-1874.

Nurse Practitioner with taxonomy code 363LP2300X and a focus in Primary Care.

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