SANJAY SURYAKANT PANCHOLI (D.O.) – Internal Medicine Physician, NPI 1780894816
Internal Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
8,824 INTERNAL MEDICINE in IL
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Provider Addresses for SANJAY SURYAKANT PANCHOLI (D.O.)
Community Health Care, 500, West River Drive, Davenport, Scott County, Iowa, 52801, United States
DAVENPORT, IA 528011014
Phone: (563) 336-3000
Fax: (563) 336-3125
Type: Mailing
2750, 11th Street, Rock Island, Rock Island County, Illinois, 61201, United States
ROCK ISLAND, IL 612015216
Phone: (563) 327-2100
Fax: (563) 327-2102
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $255.
Total Amount is formed as General ($255) + Research ($0) + Ownership ($0) = $255.
Last reported payment date: 2024-12-06 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($72).
Total Amount
$255
General + Research + Ownership
Payments
15
Total payment records
General Amount
$255
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $72 |
| PFIZER INC. | $28 |
| Astellas Pharma US Inc | $25 |
| Lilly USA, LLC | $23 |
| GlaxoSmithKline, LLC. | $20 |
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: 2015-10-02
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070807000800 | I | Internal Medicine | IL | TBD |
| I20151002000388 | I | Internal Medicine | IA | 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 | 558 | 266 | $0 |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 222 | 222 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 210 | 210 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 184 | 184 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 165 | 97 | $0 |
Insurance plans in this area (ZIP 52801)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | IL | 83036 | Hemoglobin A1C level | 143 | 90 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine, Family Practice | IN | |
| - | IA | |
| - | IA | |
| Nurse Practitioner | IA | |
| Physician Assistant | AL | |
| Internal Medicine, Hospitalist | NC | |
| - | IA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | IA | |
| - | IA |
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