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SCOTT P. FOGEL DDS PC
NPI 1750494142
Dentist - General Practice in Bourbonnais, IL

Active since August 17, 2006Opted out of Medicare · through Oct 18, 2027
1521 N CONVENT ST, SUITE 600, BOURBONNAIS, IL 60914(815) 933-5173(815) 933-5191 Get Directions Write a Review

NPPES record last updated: November 26, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Scott P. Fogel Dds Pc NPPES

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

SCOTT P. FOGEL DDS PC (NPI 1750494142) is a healthcare organization registered as a general practice in Bourbonnais, Illinois and active in the NPI registry since August 2006. The organization has opted out of Medicare through October 18, 2027 and remains eligible to order and refer and lists Scott P. Fogel, Owner, as its authorized official.

NPPES Registry Identity

NPI1750494142
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSCOTT P. FOGEL DDS PC
Location Address1521 N CONVENT ST, SUITE 600Bourbonnais, IL 60914-1468
Mailing Address1521 N Convent St, Suite 600Bourbonnais, IL 60914-1468 · (815) 933-5173 · Fax (815) 933-5191
Phone(815) 933-5173
Fax(815) 933-5191
Organization SubpartYes
Authorized OfficialScott P. FogelOwner · (815) 933-5173
Enumeration DateAugust 17, 2006
Last NPPES UpdateNovember 26, 2012
✔ NPI 1750494142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IL · 019026391
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1521 N CONVENT ST, Bourbonnais, IL 60914
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Scott P. Fogel Dds Pc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 18, 2015 through October 18, 2027.

Opt-Out Effective DateOctober 18, 2015
Opt-Out In Effect ThroughOctober 18, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60914 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMERICAN MEDICAL GROUP,LTD
Internal Medicine
1521 N CONVENT ST
BOURBONNAIS, IL 60914
Kankakee County (708) 715-7591
PANOPTIC PHYSICAL THERAPY LLC
Physical Medicine & Rehabilitation
1521 N CONVENT ST, SUITE 1000
BOURBONNAIS, IL 60914
Kankakee County (815) 210-9010
ILLINOIS LASER & VEIN CENTER, LLC
Clinic/Center (Medical Specialty)
1521 N CONVENT ST
BOURBONNAIS, IL 60914
Kankakee County (815) 937-4500
CHICAGO HEARING LLC
Hearing Aid Equipment
1521 N CONVENT ST, SUITE 300
BOURBONNAIS, IL 60914
Kankakee County (815) 768-3002

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 Scott P. Fogel Dds PC's NPI number?

The NPI number for Scott P. Fogel Dds PC is 1750494142. It was assigned to this organization in the NPPES registry on August 17, 2006.

Where is Scott P. Fogel Dds PC located?

Scott P. Fogel Dds PC is located at 1521 N Convent St Suite 600, Bourbonnais, IL 60914. The listed phone number is (815) 933-5173.

What is Scott P. Fogel Dds PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Scott P. Fogel Dds PC enrolled in Medicare?

No. Scott P. Fogel Dds PC has opted out of Medicare through October 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Scott P. Fogel Dds PC was last updated on November 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.