Individual provider Active NPI

Krupa Patel

  • Otolaryngology Physician
  • Chicago, IL
National Provider Identifier
1871029272
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036165440 Issued in IL
Practice address
1611 W Harrison St Ste 550
Chicago, IL 60612-4861
Phone
(312) 942-6100
NPI assigned
May 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 036165440 IL Primary

Addresses

Primary practice location

1611 W Harrison St Ste 550
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St Ste 550
Chicago, IL 60612-4861
Phone (312) 942-6100

Other practice location 1

243 Charles St
Boston, MA 02114-3002
Phone (617) 573-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NJ2 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
I20230912000064 IL Practitioner - Otolaryngology 2769756063 Reassigns benefits to 1 organization
I20260127000575 NJ Practitioner - Otolaryngology 2769756063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1016 Main Ave
Clifton, NJ 07011-2327

1124 W Adams St
Unit 3W
Chicago, IL 60607-0901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036165440ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Otolaryngology CurrentSince Sep 18, 2023 Accepting new patients
Rush University Medical Center CurrentSince Sep 18, 2023 Accepting new patients
NJ Eye and Ear LLC CurrentSince Jan 1, 2026 Accepting new patients
Clifton Eye Care LLC Past Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1611 W Harrison St
Ste 550
Chicago, IL 60612
Phone (312) 563-4431

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1016 Main Ave
Clifton, NJ 07011
Phone (973) 546-5700

23 W Palisade Ave
Englewood, NJ 07631
Phone (201) 408-4441

245 Engle St
Englewood, NJ 07631
Phone (201) 568-0770

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1871029272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 550",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-942-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 550",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-942-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "243 Charles St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021143002",
            "country_code": "US",
            "telephone_number": "617-573-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KRUPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-04",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036165440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.