Individual provider Active NPI

Purvi S Patel, FNP

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1881097244
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209011882 Issued in IL
Practice address
2222 E State St
Suite 209
Rockford, IL 61104-1573
Phone
(815) 988-8500
Fax
(815) 977-5956
NPI assigned
Sep 30, 2014
Last updated
Sep 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209011882 IL Primary

Addresses

Primary practice location

2222 E State St
Suite 209
Rockford, IL 61104-1573

Mailing address

2222 E State St
Suite 209
Rockford, IL 61104-1573
Phone (815) 988-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141107001187 IL Practitioner - Nurse Practitioner 6709008667 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Serene Psychiatry PLLCGroup PAC ID 9830610153, 2 clinicians

Practice addresses (Care Compare)

3490 Harold Cir
Hoffman Estates, IL 60192-2000
Phone (847) 450-0222

Merit-based Incentive Payment System (MIPS)

Final score
58.33 of 100Reported as group
Quality
41.25
Promoting interoperability
0
Improvement activities
40
Cost
69.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209011882ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychpromd LLC CurrentSince Nov 30, 2024 Accepting new patients
Serene Psychiatry PLLC CurrentSince Feb 3, 2025 Accepting new patients

Locations

836 S Arlington Heights Rd
Elk Grove Vlg, IL 60007
Phone (312) 545-2211

2300 N Barrington Rd
Ste 400
Hoffman Estates, IL 60169
Phone (815) 947-4463

3 Golf Ctr
Hoffman Estates, IL 60169

3 Golf Ctr
Ste 234
Hoffman Estates, IL 60169

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1881097244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E STATE ST",
            "address_2": "SUITE 209",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611041573",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E STATE ST",
            "address_2": "SUITE 209",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611041573",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PURVI",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.