SANJAY SURYAKANT PANCHOLI D.O.
NPI 1780894816
Internal Medicine in Rock Island, IL

Q: What is Sanjay Pancholi's NPI number?

The NPI number for Sanjay Pancholi is 1780894816. It was assigned to this individual provider in the NPPES registry on May 24, 2007.

Q: What is Sanjay Pancholi's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Sanjay Pancholi was last updated on May 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 24, 2007PECOS EnrolledAccepts Medicare Assignment

2750 11TH ST, ROCK ISLAND, IL 61201(563) 327-2100(563) 327-2102 Get Directions Write a Review

NPPES record last updated: May 25, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Sanjay Suryakant Pancholi D.o. NPPES

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

SANJAY SURYAKANT PANCHOLI D.O. (NPI 1780894816) is an individual internal medicine provider in Rock Island, Illinois, licensed in Illinois (036118253) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Genesis Hlth System Dba Genesis Mdl Ctr-illini, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1780894816

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameSANJAY SURYAKANT PANCHOLICredential: D.O.

Location Address2750 11TH STRock Island, IL 61201-5216

Mailing Address500 W River DrDavenport, IA 52801-1014 · (563) 336-3000 · Fax (563) 336-3125

Phone(563) 327-2100

Fax(563) 327-2102

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateMay 24, 2007

Last NPPES UpdateMay 25, 2021

NPPES CertifiedMay 25, 2021

✔ NPI 1780894816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036118253

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2750 11TH ST, Rock Island, IL 61201

Open in Google Maps ↗

Other Identifiers 1

Medicaid036118253IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.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

Sanjay Suryakant Pancholi D.o. 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 ID4284725110

PECOS Enrollment IDI20070807000800, I20151002000388

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 Reassignment

Medicare enrollment records show Sanjay Pancholi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Genesis Health System

4.2 mi

Psychiatric Unit

1401 W CENTRAL PARK AVE
Davenport, IA 52804

Reassigned Medicare billing, Iowa and Illinois enrollments
Also billed through NPI 1477654945 (Illinois)
300 clinicians in this Medicare group

NPI 1710276183 (563) 421-1288

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 13

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 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.

536 services267 patients

Annual alcohol misuse screening, 5 to 15 minutes G0442

An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.

245 services245 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

239 services239 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

215 services215 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

172 services113 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

88 services88 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

78 services78 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

26 services25 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

26 services23 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

25 services25 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

25 services25 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

12 services11 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Genesis Hlth System Dba Genesis Mdl Ctr-Illini

Acute Care Hospitals · Silvis, IL

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number140275

Location801 Illini DrSilvis, IL 61282 · Rock Island County

Emergency services Birthing friendly

Trinity Rock Island

Acute Care Hospitals · Rock Island, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140280

Location2701 17th StRock Island, IL 61201 · Rock Island County

Emergency services Birthing friendly

Genesis Medical Center, Aledo

Critical Access Hospitals · Aledo, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141304

Location409 NW 9th AvenueAledo, IL 61231 · Mercer County

Emergency services

Genesis Medical Center-Davenport

Acute Care Hospitals · Davenport, IA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number160033

Location1227 East Rusholme StreetDavenport, IA 52803 · Scott County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61201 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

Referred Medical Equipment & Supplies CMS DME claims 15

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

16 suppliers59 claims146 services$6.38 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

10 suppliers22 claims34 services$1.07 avg. paid by Medicare

Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone A4315

DME-Orthotic Devices · category DF000N

1 supplier11 claims11 services$18.47 avg. paid by Medicare

Irrigation tray with bulb or piston syringe, any purpose A4320

DME-Medical/Surgical Supplies · category DA000N

1 supplier11 claims11 services$3.43 avg. paid by Medicare

Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358

DME-Orthotic Devices · category DF000N

1 supplier11 claims22 services$4.64 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

3 suppliers11 claims11 services$35.05 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 12

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

COURTNEY BETH LEGENDRE FNP

Nurse Practitioner (Family)