KISHAN PATEL (MD) – Anesthesiology Physician, NPI 1790314805

KISHAN PATEL (MD) is a healthcare provider. based in Park ridge, Illinois. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. A199804 (CA). The NPI Number for KISHAN PATEL (MD) is 1790314805

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
KISHAN PATEL (MD)
NPI
1790314805
Phone
Not provided
Address
1775 DEMPSTER ST
Enumeration Date
2 April 2020
Last Update Date
20 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3108323311
Graduation Year
2024 (2 years ago)
PAC ID
5991249328
Group Practice PAC ID
4385070549
Professional Enrollment ID
I20250422002922
Address ID
CA907323505SA1300XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness85
Years active:6State licenses:2Digital endpointsOther names

2,633 ANESTHESIOLOGY in IL

Provider Addresses for KISHAN PATEL (MD)

  • 1775 DEMPSTER ST

    8 SOUTH, MAILBOX 48

    PARK RIDGE, IL 600681143

    Phone:

    Type: Mailing

  • 1775 BALLARD RD

    PARK RIDGE, IL 600681005

    Phone: (847) 318-9340

    Type: Location

  • PO BOX 6359

    MESA, AZ 852166359

    Phone: (480) 309-7979

    Type: Mailing

  • 1955 W FRYE RD

    CHANDLER, AZ 852246282

    Phone: (480) 507-2961

    Type: Location

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: 2025-04-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240626004056IAnesthesiologyAZTBD
I20250422002922IAnesthesiologyCATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60068)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385070549View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YFL
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YCA
Certified Registered Nurse Anesthetist (Crna)TX
A N E S T H E S I O L O G YCA

Reviews

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Frequently asked questions

How do payers reference KISHAN PATEL (MD)?
For KISHAN PATEL (MD), use NPI 1790314805 as the unique 10-digit identifier.
Is KISHAN PATEL (MD) shown as active in public data?
Registry records indicate KISHAN PATEL (MD) maintains an active NPI.
What kind of doctor is KISHAN PATEL (MD)?
KISHAN PATEL (MD) is associated with Anesthesiology Physician in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for KISHAN PATEL (MD)?
Travel planning: use Park Ridge, Illinois as the reference point for KISHAN PATEL (MD), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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