NPI registry status
Active
2026 NPPES data Otolaryngology Physician NPI 1851684617 M.D.
Verify on CMS → Hetal Patel, M.D.
Otolaryngology Physician in Peoria, Illinois.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 10,893 in Otolaryngology Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
228
Medicare Part D claims · 115 beneficiaries · Otolaryngology Physician avg: 509
Generic prescribing
93%
generic claims · 7% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
71.8/100
▼ 11 pts below national avg 83.1 · Mid-tier
Industry payments
$467.67
14 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Hetal Patel, M.D. reported a CMS MIPS final score of 71.8/100 - below the 83.1 national average - and filed 228 Medicare Part D claims in 2023.
- 71.8/100
- MIPS score · -11 vs avg
- 228
- Part D claims, 2023
- 93%
- generic prescribing
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Hetal Patel, M.D.'s MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
72 9th percentile higher than 9% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Hetal Patel, M.D. sits
This provider among otolaryngology physician peers
Across the 3,669 otolaryngology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Hetal Patel, M.D. writes more Part D claims than 30% of them and scores higher on MIPS quality than 15% - placing this provider in the lower-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one otolaryngology physician peer from a representative sample of 60; the gold marker is Hetal Patel, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Hetal Patel, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Hetal Patel, M.D.?
Below national averagePrimary specialty
Otolaryngology Physician
Medicare Part D claims
228 55% vs specialty avg
MIPS final score
71.8/100 11.3 pts vs avg
Specialty distribution in Illinois
How Otolaryngology Physician compares to other specialties among Illinois providers
Medicare quality performance, MIPS
Hetal Patel, M.D.'s 2023 MIPS final score plotted against the Otolaryngology Physician national average
- MIPS Final Score
- 71.8/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Otolaryngology Physician) - 71.8/100 vs national avg 83.1
How MIPS and board certification work
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Hetal Patel, M.D. appears in the CMS NPPES registry as an Otolaryngology Physician provider holding M.D. credentials at 7301 KNOXVILLE AVE, Peoria, IL, 61614, with a listed phone of (309) 589-5900. NPI 1851684617 was issued on 05/25/2011.
Medicare Part D records for calendar year 2023 show 228 prescription claims written by this provider, covering 115 Medicare beneficiaries and totaling roughly $20K in drug spend, split 7% brand-name and 93% generic by claim count, with an opioid prescribing rate of 6.1%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 71.8/100 for the 2023 performance year (Quality 49.8), compared with the national average of 83.1.
Otolaryngology Physician is a mid-sized specialty nationwide, with 10,893 enrolled providers across 54 states and an average of 509 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline.
Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1851684617 |
|---|---|
| Specialty | Otolaryngology Physician |
| Credentials | M.D. |
| Gender | Female |
| NPI Issued | 05/25/2011 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
71.7885
Final Score
Avg: 83.1
49.7973
Quality
98
Promoting Interoperability
Reporting: Individual
Hospital and facility affiliations
Facilities where Hetal Patel, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Peoria Ear Nose And Throat Group SC
Peoria, IL
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Hetal Patel, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$468
Largest payer
Octapharma USA, Inc.
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
License & disciplinary context - Illinois IDFPR 2023 annual report
Aggregate state board data only, NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~42K Illinois medical licensees in 2023 - they are NOT specific to Hetal Patel, M.D.. To verify Hetal Patel, M.D.'s current license status, search the IDFPR public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
106
Total board actions, Illinois 2023
Across 103 cases
2.52
Actions per 1,000 licensees
Illinois statewide rate
probation
Most common action type
38 cases
IDFPR publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Illinois disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Brand vs generic prescribing mix · Generic-heavy
Hetal Patel, M.D. - brand share 7.0%
Otolaryngology Physician average
7% brand-name claims vs 93% generic, on 228 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
228
Total Claims
$20K
Total Drug Cost
115
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 299
- Total Day Supply
- 6,755
- Brand vs Generic
- 7% brand / 93% generic
- Brand Drug Cost
- $15K
- Generic Drug Cost
- $5K
- Opioid Claims
- 14 (6.1% rate)
- Antibiotic Claims
- 27
Patient Demographics
- Average Patient Age
- 72.4 years
- Avg HCC Risk Score
- 1.31
- Gender Split
- 59% female / 41% male
- Age Distribution
- <65: 12, 65-74: 51, 75-84: 40, 85+: 12
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Hetal Patel, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Fluticasone Propio…
Fluticasone Propionate
42 claims
- Ipratropium Bromide
Ipratropium Bromide
25 claims
- Amoxicillin-Clavul…
Amoxicillin-Clavulanate Potass
19 claims
- Ofloxacin 16
Ofloxacin
16 claims
- Omeprazole 14
Omeprazole
14 claims
- Hydrocodone-Acetam… 13
Hydrocodone-Acetaminophen
13 claims
- Fluocinolone Aceto… 12
Fluocinolone Acetonide Oil
12 claims
- Pilocarpine Hcl 12
Pilocarpine Hcl
12 claims
| Drug | Claims |
|---|---|
| Fluticasone Propionate | 42 |
| Ipratropium Bromide | 25 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 19 |
| Ofloxacin | 16 |
| Omeprazole | 14 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 13 |
| Fluocinolone Acetonide Oil | 12 |
| Pilocarpine Hcl | 12 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Otolaryngology Physician Overview
How Hetal Patel, M.D. fits within the Otolaryngology Physician landscape nationally.
10,893
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
509
Avg Claims per Provider
Hetal Patel, M.D.'s 228 claims are below the specialty average of 509.
Nearby Otolaryngology Physician Providers in Illinois
Other clinicians with the same primary specialty enrolled in Illinois, drawn from the same CMS NPPES roster as Patel.
Dr. Neil Aaronson
M.D.
Highland Park, IL
Nathan Ackerman
Champaign, IL
Murtala Affini
Chicago, IL
Nishant Agrawal
Chicago, IL
Dr. Samer Al-Khudari
M.D.
Chicago, IL
Compare Otolaryngology Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the Illinois medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Otolaryngology Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Frequently Asked Questions
What is Hetal Patel, M.D.'s specialty? ▼
Hetal Patel, M.D. specializes in Otolaryngology Physician and practices in Peoria, Illinois. Credentials: M.D..
How much does Hetal Patel, M.D. prescribe under Medicare Part D? ▼
In 2023, Hetal Patel, M.D. wrote 228 Medicare Part D claims totaling $20K in drug costs for 115 beneficiaries.
What is Hetal Patel, M.D.'s Medicare quality score? ▼
Hetal Patel, M.D. has a CMS MIPS Final Score of 71.8/100 (Quality: 49.8). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Hetal Patel, M.D. located? ▼
Hetal Patel, M.D. is located at 7301 KNOXVILLE AVE, Peoria, IL, 61614. Phone: (309) 589-5900.
What is Hetal Patel, M.D.'s NPI number? ▼
Hetal Patel, M.D.'s National Provider Identifier (NPI) is 1851684617, issued on 05/25/2011.
Does Hetal Patel, M.D. prescribe more brand-name or generic drugs? ▼
Hetal Patel, M.D.'s prescribing is 7% brand-name and 93% generic drugs by claim count, with $15K in brand drug costs.
Does Hetal Patel, M.D. prescribe opioids? ▼
Yes, Hetal Patel, M.D. had 14 opioid claims in 2023 with an opioid prescribing rate of 6.1%.
How many Otolaryngology Physician providers are there in the US? ▼
There are 10,893 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 509 Medicare Part D claims per year.
What drugs does Hetal Patel, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Hetal Patel, M.D.'s most frequently prescribed drugs include Fluticasone Propionate, Ipratropium Bromide, Amoxicillin-Clavulanate Potass. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Hetal Patel, M.D. accept Medicare? ▼
Hetal Patel, M.D. appears in CMS Medicare data with 228 Part D claims and 115 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Hetal Patel, M.D.'s credentials? ▼
Hetal Patel, M.D.'s NPI is 1851684617 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology
Compiled from official public sources by the PlainDoctor editorial team.
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.