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HETAL PATEL M.D.
NPI 1851684617
Otolaryngology in Peoria, IL

Active since May 25, 2011PECOS EnrolledAccepts Medicare Assignment
71.78/100
CMS Quality Rating
7301 KNOXVILLE AVE, PEORIA, IL 61614(309) 589-5900 Get Directions Write a Review

NPPES record last updated: October 2, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Hetal Patel M.d. NPPES

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

HETAL PATEL M.D. (NPI 1851684617) is an individual otolaryngology provider in Peoria, Illinois, licensed in Florida (ME128163) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS, is affiliated with Proctor Hospital, and is a graduate of Saint Louis University School Of Medicine (2011).

NPPES Registry Identity

NPI1851684617
Entity TypeIndividualFemale
Primary Taxonomy207Y00000X
Provider Legal NameHETAL PATELCredential: M.D.
Location Address7301 KNOXVILLE AVEPeoria, IL 61614
Mailing Address7301 Knoxville AvePeoria, IL 61614 · (309) 589-5900
Phone(309) 589-5900
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 2011
Enumeration DateMay 25, 2011
Last NPPES UpdateOctober 2, 2017
✔ NPI 1851684617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in FL · ME128163
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
7301 KNOXVILLE AVE, Peoria, IL 61614
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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

Hetal Patel 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 ID6305133448
PECOS Enrollment IDI20171024002476
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 8

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.
193 services133 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.
139 services106 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.
114 services114 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
84 services74 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
24 services21 patients
Incision of fluid canal of inner ear with infusion of drugs 69801
This procedure involves making a small cut in the inner ear's fluid canal. Medication is then infused directly into this area. It's often used to treat certain ear conditions or hearing issues. Rest assured, it's done under professional supervision.
20 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Proctor Hospital

Acute Care Hospitals · Peoria, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140013
Location5409 N Knoxville AvePeoria, IL 61614 · Peoria County
Emergency services

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Pekin Memorial Hospital

Acute Care Hospitals · Pekin, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140120
Location600 South 13th StreetPekin, IL 61554 · Tazewell County
Emergency services

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140209
Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61614 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
$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.

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.

71.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality49.79
Promoting Interoperability98
Improvement Activities40

Reported Quality Measures

Appropriate Treatment for Upper Respiratory Infection (URI)
96%23 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
93%2,035 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
26%538 patients2/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
94%587 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
64%128 patients3/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 568 patients
Patients totalRate: 0% · 568 patients
0%568 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Hetal Patel's NPI number?

The NPI number for Hetal Patel is 1851684617. It was assigned to this individual provider in the NPPES registry on May 25, 2011.

Where is Hetal Patel located?

Hetal Patel practices at 7301 Knoxville Ave, Peoria, IL 61614. The listed phone number is (309) 589-5900.

What is Hetal Patel's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Hetal Patel enrolled in Medicare?

Yes. Hetal Patel 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 Hetal Patel affiliated with any hospitals?

According to CMS data, Hetal Patel is affiliated with Proctor Hospital, Saint Francis Medical Center, Pekin Memorial Hospital and Methodist Medical Center Of Illinois.

When was this NPI record last updated?

The NPPES record for Hetal Patel was last updated on October 2, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.