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DR. PUJA SETHI M.D.
NPI 1760753271
Family Medicine - Sleep Medicine in Woodridge, IL

Active since January 16, 2012PECOS EnrolledAccepts Medicare Assignment
80.83/100
CMS Quality Rating
7530 WOODWARD AVE STE A, WOODRIDGE, IL 60517(630) 297-8282(630) 278-6118 Get Directions Write a Review

NPPES record last updated: May 25, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 25, 2023, Feb 27, 2023, Mar 17, 2021 (3 updates tracked since 2021).

About Dr. Puja Sethi M.d. NPPES

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

DR. PUJA SETHI M.D. (NPI 1760753271) is an individual sleep medicine provider in Woodridge, Illinois, licensed in Illinois (36129334) and active in the NPI registry since January 2012. She is enrolled in Medicare PECOS, is affiliated with Mt Sinai Hospital Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1760753271
Entity TypeIndividualFemale
Primary Taxonomy207QS1201X
Provider Legal NameDR. PUJA SETHICredential: M.D.
Location Address7530 WOODWARD AVE STE AWoodridge, IL 60517-3100
Mailing Address1314 Kensington Rd., Unit 3161Oak Brook, IL 60522-3161 · (630) 297-8282 · Fax (630) 278-6118
Phone(630) 297-8282
Fax(630) 278-6118
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateJanuary 16, 2012
Last NPPES UpdateMay 25, 20233 updates tracked since enumeration
NPPES CertifiedMay 25, 2023
✔ NPI 1760753271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS1201X
License✔ Licensed in IL · 36129334
Definition
A Family Medicine Physician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 036-129334 (IL)
7530 WOODWARD AVE STE A, Woodridge, IL 60517
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11500 S Fairfield AveChicago, IL 60608-1782 · Phone (773) 542-2000
Location 2908 N Elm St Ste 306Hinsdale, IL 60521-3625 · Phone (630) 323-5214 · Fax (630) 323-5215

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

Dr. Puja Sethi 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 ID4082869904
PECOS Enrollment IDI20130226000614
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 7

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
104 services56 patients
Sleep study including heart rate, breathing, and sleep time 95800
A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.
51 services51 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
36 services28 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
35 services34 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
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.
34 services34 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
28 services28 patients

Hospital Affiliations CMS Care Compare 3

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

Mt Sinai Hospital Medical Center

Acute Care Hospitals · Chicago, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140018
Location1500 S Fairfield AveChicago, IL 60608 · Cook County
Emergency services Birthing friendly

Adventist Hinsdale Hospital

Acute Care Hospitals · Hinsdale, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140122
Location120 North Oak StHinsdale, IL 60521 · Du Page County
Emergency services Birthing friendly

Advocate Good Samaritan Hospital

Acute Care Hospitals · Downers Grove, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140288
Location3815 Highland AvenueDowners Grove, IL 60515 · Du Page County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60517 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.

80.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.96
Promoting Interoperability72
Improvement Activities40
Cost63.15

Referred Medical Equipment & Supplies CMS DME claims 17

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
24 suppliers203 claims203 services$33.40 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
18 suppliers149 claims149 services$69.61 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
19 suppliers167 claims423 services$27.33 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
17 suppliers99 claims468 services$15.10 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
13 suppliers59 claims302 services$12.87 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
23 suppliers134 claims134 services$46.08 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 4

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

WINSTON THEIN-WAI M.D
Internal Medicine (Endocrinology, Diabetes & Metabolism)
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 910-1177
MADHURI UPPALAPATI M.D.
Family Medicine (Sleep Medicine)
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 484-5911
SLEEP MATTERS, LTD.
Family Medicine (Sleep Medicine)
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 297-8282
VIJAYKUMAR C PATEL, M.D
Family Medicine
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 910-1177

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 Puja Sethi's NPI number?

The NPI number for Puja Sethi is 1760753271. It was assigned to this individual provider in the NPPES registry on January 16, 2012.

Where is Puja Sethi located?

Puja Sethi practices at 7530 Woodward Ave Ste A, Woodridge, IL 60517. The listed phone number is (630) 297-8282.

What is Puja Sethi's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sleep Medicine, with taxonomy code 207QS1201X.

Is Puja Sethi enrolled in Medicare?

Yes. Puja Sethi 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.

Is Puja Sethi affiliated with any hospitals?

According to CMS data, Puja Sethi is affiliated with Mt Sinai Hospital Medical Center, Adventist Hinsdale Hospital and Advocate Good Samaritan Hospital.

When was this NPI record last updated?

The NPPES record for Puja Sethi was last updated on May 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.