MERAT KARBASIAN-ESFAHANI M.D.
NPI 1992740963
Internal Medicine - Hematology & Oncology in Rockford, IL

Q: What is Merat Karbasian-esfahani's NPI number?

The NPI number for Merat Karbasian-esfahani is 1992740963. It was assigned to this individual provider in the NPPES registry on June 16, 2006.

Q: What is Merat Karbasian-esfahani's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Active since June 16, 2006PECOS EnrolledAccepts Medicare Assignment

74.98/100

CMS Quality Rating

3535 N BELL SCHOOL RD, ROCKFORD, IL 61114(779) 696-9400 Get Directions Write a Review

NPPES record last updated: February 19, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 19, 2021, Oct 2, 2019, Jul 27, 2018 (3 updates tracked since 2018).

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About Merat Karbasian-esfahani M.d. NPPES

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

MERAT KARBASIAN-ESFAHANI M.D. (NPI 1992740963) is an individual hematology & oncology provider in Rockford, Illinois, licensed in Illinois (036118996) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Katherine Shaw Bethea Hospital, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1992740963

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameMERAT KARBASIAN-ESFAHANICredential: M.D.

Location Address3535 N BELL SCHOOL RDRockford, IL 61114

Mailing AddressPo Box 78866Milwaukee, WI 53278-8866

Phone(779) 696-9400

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateJune 16, 2006

Last NPPES UpdateFebruary 19, 20213 updates tracked since enumeration

NPPES CertifiedFebruary 19, 2021

✔ NPI 1992740963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in IL · 036118996

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

3535 N BELL SCHOOL RD, Rockford, IL 61114

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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 and more.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

Merat Karbasian-esfahani 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 ID5698873438

PECOS Enrollment IDI20071013000032

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 9

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.

532 services224 patients

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.

188 services88 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.

131 services115 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.

53 services53 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

42 services25 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.

42 services19 patients

Hospital Affiliations CMS Care Compare 3

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

Katherine Shaw Bethea Hospital

Acute Care Hospitals · Dixon, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140012

Location403 E 1st StDixon, IL 61021 · Lee County

Emergency services Birthing friendly

Uw Health

Acute Care Hospitals · Rockford, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140228

Location1401 East State StreetRockford, IL 61104 · Winnebago County

Emergency services Birthing friendly

Saint Anthony Medical Center

Acute Care Hospitals · Rockford, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140233

Location5666 East State StreetRockford, IL 61108 · Winnebago County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61114 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

$168.44 typical visit price

range $54.80 – $168.44

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

Most-billed visit code 99205

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.

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.

74.98/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

79.92

Promoting Interoperability

Improvement Activities

Cost

55.01

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.

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