NISTHA RAWAL DO
NPI 1801323159
Internal Medicine - Gastroenterology in Lake Barrington, IL

Q: What is Nistha Rawal's NPI number?

The NPI number for Nistha Rawal is 1801323159. It was assigned to this individual provider in the NPPES registry on May 17, 2017.

Q: What is Nistha Rawal's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nistha Rawal was last updated on August 9, 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.

Active since May 17, 2017PECOS EnrolledAccepts Medicare Assignment

22285 N PEPPER RD STE 311, LAKE BARRINGTON, IL 60010(847) 382-4410 Get Directions Write a Review

NPPES record last updated: August 9, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 9, 2023, Jul 21, 2022, May 17, 2017 (3 updates tracked since 2017).

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About Nistha Rawal Do NPPES

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

NISTHA RAWAL DO (NPI 1801323159) is an individual gastroenterology provider in Lake Barrington, Illinois, licensed in Illinois (036.165378) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Mchenry, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2017).

NPPES Registry Identity

NPI1801323159

Entity TypeIndividualFemale

Primary Taxonomy207RG0100X

Provider Legal NameNISTHA RAWALCredential: DO

Location Address22285 N PEPPER RD STE 311Lake Barrington, IL 60010-2541

Mailing Address350 N Wall StKankakee, IL 60901-2901 · (815) 928-6274

Phone(847) 382-4410

Sole ProprietorNo

Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 2017

Enumeration DateMay 17, 2017

Last NPPES UpdateAugust 9, 20233 updates tracked since enumeration

NPPES CertifiedAugust 9, 2023

✔ NPI 1801323159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in IL · 036.165378

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.

22285 N PEPPER RD STE 311, Lake Barrington, IL 60010

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Nistha Rawal Do 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 ID648515338

PECOS Enrollment IDI20230822001000

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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

239 services166 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

95 services92 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.

82 services79 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.

68 services68 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.

64 services64 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.

60 services52 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.

53 services53 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.

43 services40 patients

Biopsy of large bowel using a flexible endoscope 45380

16 services16 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

13 services13 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

13 services13 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

12 services11 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Northwestern Medicine Mchenry

Acute Care Hospitals · Mchenry, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140116

Location4201 Medical Center DriveMchenry, IL 60050 · Mc Henry County

Emergency services Birthing friendly

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

Advocate Good Shepherd Hospital

Acute Care Hospitals · Barrington, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140291

Location450 West Highway 22Barrington, IL 60010 · Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60010 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

$137.43 typical visit price

range $59.81 – $181.38

Typical copayment $34.35 (range $14.95 – $45.34)

Most-billed visit code 99204

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.

Other Providers at the Same Location NPPES 2

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

ERIN E MICKLINGHOFF CNP

Nurse Practitioner (Adult Health)

22285 N PEPPER RD STE 311
LAKE BARRINGTON, IL 60010

Cook County (847) 382-4410

NICOLE M GENTILE MD

Internal Medicine (Gastroenterology)

22285 N PEPPER RD STE 311
LAKE BARRINGTON, IL 60010

Cook County (847) 382-4410

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 Nistha Rawal's NPI number?

The NPI number for Nistha Rawal is 1801323159. It was assigned to this individual provider in the NPPES registry on May 17, 2017.

Where is Nistha Rawal located?

Nistha Rawal practices at 22285 N Pepper Rd Ste 311, Lake Barrington, IL 60010. The listed phone number is (847) 382-4410.

What is Nistha Rawal's specialty?

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

Is Nistha Rawal enrolled in Medicare?

Yes. Nistha Rawal 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.

What insurance does Nistha Rawal accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Nistha Rawal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nistha Rawal affiliated with any hospitals?

According to CMS data, Nistha Rawal is affiliated with Northwestern Medicine Mchenry, Northwestern Medicine Central Dupage Hospital and Advocate Good Shepherd Hospital.

When was this NPI record last updated?

The NPPES record for Nistha Rawal was last updated on August 9, 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.