DR. KIRBYLEE KRISTINA NELSON M.D.
NPI 1780927418
Internal Medicine - Gastroenterology in Chicago, IL

Active since April 01, 2013PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
259 E ERIE ST STE 1600, CHICAGO, IL 60611(312) 695-5620(312) 695-2729 Get Directions Write a Review

NPPES record last updated: October 6, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 6, 2020, May 22, 2017 (2 updates tracked since 2017).

About Dr. Kirbylee Kristina Nelson M.d. NPPES

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

DR. KIRBYLEE KRISTINA NELSON M.D. (NPI 1780927418) is an individual gastroenterology provider in Chicago, Illinois, licensed in Illinois (036143534) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and maintains a secondary practice location in Tampa.

NPPES Registry Identity

NPI1780927418
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameDR. KIRBYLEE KRISTINA NELSONCredential: M.D.
Location Address259 E ERIE ST STE 1600Chicago, IL 60611-3111
Mailing Address259 E Erie St Ste 1600Chicago, IL 60611-3111 · (312) 695-5620 · Fax (312) 695-2729
Fax(312) 695-2729
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 2013
Enumeration DateApril 1, 2013
Last NPPES UpdateOctober 6, 20202 updates tracked since enumeration
NPPES CertifiedOctober 6, 2020
NPI 1780927418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses Licensed in IL · 036143534 Licensed in NY · 285255
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
259 E ERIE ST STE 1600, Chicago, IL 60611

Secondary Practice Location 1

Location 112901 Bruce B Downs Blvd, MDC 41Tampa, FL 33612-4742 · Phone (813) 844-7412 · Fax (813) 974-8359

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. Kirbylee Kristina Nelson 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 ID3375880073
PECOS Enrollment IDI20200820000502
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 6

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.
60 services38 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
48 services48 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
32 services32 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
23 services23 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.
15 services15 patients
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito G0500
Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140242
Location25 North Winfield RoadWinfield, IL 60190 · Du Page County
Emergency services Birthing friendly

Northwestern Memorial Hospital

Acute Care Hospitals · Chicago, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140281
Location251 E Huron StChicago, IL 60611 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60611 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.59
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

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

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
3 suppliers15 claims459 services$4.99 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
3 suppliers15 claims8,465 services$0.29 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 20

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

Nurse Practitioner
259 E ERIE ST STE 1600
CHICAGO, IL 60611
Surgery (Trauma Surgery)
259 E ERIE ST STE 1600
CHICAGO, IL 60611
Internal Medicine (Hepatology)
259 E ERIE ST STE 1600
CHICAGO, IL 60611
Internal Medicine (Gastroenterology)
259 E ERIE ST STE 1600
CHICAGO, IL 60611
Dietitian, Registered
259 E ERIE ST STE 1600
CHICAGO, IL 60611
Physician Assistant
259 E ERIE ST STE 1600
CHICAGO, IL 60611
Nurse Practitioner
259 E ERIE ST STE 1600
CHICAGO, IL 60611
Physician Assistant
259 E ERIE ST STE 1600
CHICAGO, IL 60611

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 Kirbylee Nelson's NPI number?

The NPI number for Kirbylee Nelson is 1780927418. It was assigned to this individual provider in the NPPES registry on April 1, 2013.

Where is Kirbylee Nelson located?

Kirbylee Nelson practices at 259 E Erie St Ste 1600, Chicago, IL 60611. The listed phone number is (312) 695-5620.

What is Kirbylee Nelson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Kirbylee Nelson enrolled in Medicare?

Yes. Kirbylee Nelson 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 Kirbylee Nelson affiliated with any hospitals?

According to CMS data, Kirbylee Nelson is affiliated with Northwestern Medicine Central Dupage Hospital and Northwestern Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Kirbylee Nelson was last updated on October 6, 2020. 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.