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Active NPI 1134181829 Individual Practitioner Male Practitioner

Dr. Sanjay Pethkar , MD

Internal Medicine • Plainfield, IL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Sanjay Pethkar, MD is a certified Internal Medicine practicing in Plainfield, IL. With approximately 36 years of clinical experience since completing medical education in 1990, Dr. Pethkar delivers high-quality medical care to the local community at 13415 S ROUTE 59.

Dr. Pethkar is affiliated with Sanjay Pethkar, M.D., S. C. and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include chronic care management services, first, established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

13415 S Route 59

Plainfield, IL 605855676

Telephone 8156093627
Fax 8156091328
Associated Practice Facility / Clinic
🏢 Sanjay Pethkar, M.d., S. C. Facility NPI 1588873293

Medicare Profile & Education

Medical School

Other

Graduation Year

1990

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Plainfield, IL

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
36 Yrs +12.7 yrs vs City Avg
City Avg: 23.3 Yrs
State Avg: 28.9 Yrs
Regional Practice Density
15 Specialists

Practicing in Plainfield, IL (7544 Statewide)

Telehealth Adoption Rate
40.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
39.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Pethkar (36 Years) 36 Yrs
Plainfield Specialty Average (23.3 Years) 23.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
939 96 $75.00 $64.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
464 124 $189.02 $129.27
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's
243 103 $35.00 $16.06
99497 Advance care planning, first 30 minutes
96 91 $117.00 $83.77
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
93 93 $225.00 $132.96
G0444 Annual depression screening, 5 to 15 minutes
90 90 $26.00 $19.37
G0136 Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes
87 82 $45.00 $19.27
99213 Established patient office or other outpatient visit, typically 15 minutes
78 47 $144.95 $90.75
82947 Blood glucose (sugar) level
75 37 $25.00 $3.80
G0008 Administration of influenza virus vaccine
69 68 $55.00 $33.45
90662 Influenza vaccine split virus, preservative free
53 53 $85.00 $80.09
93000 Routine ekg using at least 12 leads including interpretation and report
28 28 $38.64 $14.88
87804 Detection test by immunoassay with direct visual observation for influenza virus
22 11 $55.00 $16.22
90656 Vaccine for influenza for administration into muscle, 0.5 ml dosage
18 18 $36.00 $21.90
81003 Automated urinalysis test
18 13 $25.00 $2.09
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
15 15 $95.00 $40.55

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License IL 036091255

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
036091255 (IL)

Hospital & Practice Group Affiliations

Sanjay Pethkar, M.d., S. C.

13415 S Route 59, Plainfield, IL 605855676

Phone: 8156093627

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Mary Hensley , NP

Nurse Practitioner - Family

NPI 1184766735

Nurse Practitioner

Gabriel Lemus , NP

Nurse Practitioner - Adult Health

NPI 1285821868

Nurse Practitioner

NPI 1376791368

Doctor of Medicine (M.D.)

Ana Aguirre Ruvalcaba , APRN

Nurse Practitioner - Family

NPI 1386340784

Advanced Practice Registered Nurse

NPI 1467767566

Doctor of Medicine (M.D.)

NPI 1669434353

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 15, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location November 15, 2011

Registered at 13415 S ROUTE 59, PLAINFIELD, IL 605855676 (Tel: 8156093627)

📍
Updated Business Mailing Address November 15, 2011

Registered at PO BOX 9200, NAPERVILLE, IL 605670200 (Tel: 8156093627)

👤
Provider Name / Credentials Updated November 15, 2011

Recorded as SANJAY PETHKAR, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2011

Internal Medicine (License #036091255 in IL)

🟢
Initial NPI Registration & Enumeration April 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1134181829
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 06, 2006
Last Update: November 15, 2011
Sole Proprietor: No

Mailing Address

Po Box 9200

Naperville, IL 605670200

Phone: 8156093627

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.