MR. PRADIP SETHI (MD) – Sleep Medicine (Psychiatry & Neurology) Physician, NPI 1013009653
Sleep Medicine (Psychiatry & Neurology) Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,188 NEUROLOGY in IL
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Provider Addresses for MR. PRADIP SETHI (MD)
40, North Airlite Street, Fox River Acres, Elgin, Elgin Township, Kane County, Illinois, 60123, United States
SUITE 2
ELGIN, IL 601234965
Phone: (847) 695-0985
Fax: (847) 695-4373
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-09-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040914000030 | I | Neurology | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 409 | 215 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 171 | 142 | $0 |
| 95811 | Sleep study in sleep lab with continuous airway pressure (6 years or older) | 74 | 70 | $0 |
| 95810 | Sleep study in sleep lab (6 years or older) | 37 | 37 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 35 | 35 | $0 |
Insurance plans in this area (ZIP 60123)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NEUROLOGY | IL | 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 79 | 68 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | IL |
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