Individual provider Active NPI

Shetal Patel, MD

  • Hospitalist Physician
  • Rockford, IL
National Provider Identifier
1013938513
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036105042 Issued in IL
Practice address
2400 N Rockton Ave
Rockford, IL 61103-3619
Phone
(815) 971-5000
Fax
(630) 527-5526
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036105042 IL Primary
Hospitalist Physician 208M00000X 01069061A IN

Addresses

Primary practice location

2400 N Rockton Ave
Rockford, IL 61103-3619

Mailing address

2400 N Rockton Ave.
Rockford, IL 61103-3619
Phone (815) 971-5000

Other identifiers 2

IdentifierTypeStateIssuer
036105042MedicaidIL
BCBSOtherIL2220936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080402000709 IL Practitioner - Internal MedicinePractitioner - Hospitalist 6709963622 Reassigns benefits to 4 organizations
I20120711000306 IN Practitioner - Internal MedicinePractitioner - Hospitalist 6709963622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

1606 N 7TH St
Vituity
Terre Haute, IN 47804-2706
Phone (812) 238-7000

Hospital & facility affiliations

  • Community Hospital Hospital, Munster, IN, CCN 150125
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01069061AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Nov 14, 2011 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
KND Development 59 LLC Hospitalist Current Accepting new patients
Sound Physicians of Illinois, LLC Hospitalist CurrentSince May 1, 2023 Accepting new patients
KND Development 59, LLC Hospitalist CurrentSince May 1, 2022 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Nov 11, 2021 Accepting new patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Macoupin Physician Services, PC Hospitalist CurrentSince Nov 1, 2021 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Nov 14, 2011 Accepting new patients
KND Development 59, LLC Hospitalist CurrentSince May 1, 2022 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Nov 11, 2021 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

20733 N Broad St
Carlinville, IL 62626
Phone (217) 854-3141

2544 W Montrose Ave
Chicago, IL 60618
Phone (773) 267-2622

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

29373 Network Pl
Chicago, IL 60673

6130 N Sheridan Rd
Chicago, IL 60660
Phone (773) 381-1222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

225 Edward St
Sycamore, IL 60178
Phone (815) 225-2144

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1013938513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ROCKTON AVE.",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033619",
            "telephone_number": "815-971-5000",
            "fax_number": "630-527-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033619",
            "telephone_number": "815-971-5000",
            "fax_number": "630-527-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHETAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036105042",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01069061A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105042",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2220936",
            "identifier": "BCBS",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.