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2026 NPPES data Otolaryngology Physician NPI 1851684617 M.D.
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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 11,060 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
300
Medicare Part D claims · 142 beneficiaries · Otolaryngology Physician avg: 536
Generic prescribing
89%
generic claims · 11% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
71.8/100
▼ 12 pts below national avg 83.5 · Mid-tier
Industry payments
$467.67
14 payments · CMS Open Payments (Sunshine Act)
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

Hetal Patel, M.D. reported a CMS MIPS final score of 71.8/100 - below the 83.5 national average - and filed 300 Medicare Part D claims in 2024.

71.8/100
MIPS score · -12 vs avg
300
Part D claims, 2024
89%
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.

Federal trust snapshot

What official records show about Hetal Patel, M.D.

Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.

  • Verified

    NPI registry status

    Active listing in the CMS National Provider Identifier Registry (NPI 1851684617), first enumerated 05/25/2011.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 300 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.

    Source: CMS Part D Prescriber PUF

  • Reported

    CMS quality reporting (MIPS)

    Reported a CMS MIPS final score of 71.8/100 in the Quality Payment Program — a federal quality measure, not a patient review.

    Source: CMS Quality Payment Program

  • Reported

    Board certification signal

    Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.

    Source: NUCC taxonomy + CMS participation heuristic

  • Reported

    Hospital affiliations

    1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.

    Source: CMS Care Compare

  • Reported

    Industry payment transparency

    $467.67 in reported industry payments (14 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.

    Source: CMS Open Payments

  • State context

    State board disciplinary context

    Illinois statewide board action statistics are published annually — these figures describe aggregate state activity, not Hetal Patel, M.D.'s individual license status. Verify directly with the state medical board.

    Source: IDFPR annual report 2023

  • Not in federal data

    Individual sanction lookup

    PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.

    Source: State medical board / FSMB

This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.

CMS NPPES provider registry desk

NPI 1851684617 · Otolaryngology Physician

NPI-10 · ENUM-MID · TAX-MID · MIPS-LOW · RX-LIGHT · BOOK-THIN · PHOTO-FINISH

  • NPI-10 1851684617
  • ENUM-MID 2011
  • TAX-MID 11K Otolaryngology Physician
  • MIPS-LOW 71.8/100
  • RX-LIGHT 300
  • BOOK-THIN 455 in Illinois
  • PHOTO-FINISH Craig Bollig, M.D. · ±0.0

MIPS final-score neighbourhood

Same-specialty nationwide peers by CMS final score, not geographic proximity

MIPS pts

What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).

Source CMS Quality Payment Program (MIPS) As of 2023

Hetal Patel, M.D.'s MIPS score vs every measured U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.

72 ≥ 9th percentile 9% of 454,083 measured providers are in lower value bands

0–10: 8,684 measured providers (2%). Below this entry. 10–20: 3,008 measured providers (1%). Below this entry. 20–30: 3,069 measured providers (1%). Below this entry. 30–40: 2,746 measured providers (1%). Below this entry. 40–50: 2,928 measured providers (1%). Below this entry. 50–60: 5,882 measured providers (1%). Below this entry. 60–70: 13,906 measured providers (3%). Below this entry. 70–80: 94,570 measured providers (21%). This entry sits in this band. 80–90: 129,887 measured providers (29%). Above this entry. 90+: 189,403 measured providers (42%). Above this entry. This provider 0 100 every measured MIPS clinician, bucketed by value

Each bar is a band; taller bars hold more measured 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.

The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where Hetal Patel, M.D. sits

This provider among otolaryngology physician peers

Across the 3,290 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 39% of them and scores higher on MIPS quality than 16% - placing this provider in the lower-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality0255075100024.448.873.297.7Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 83Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 70Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 77Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 18Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 47Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 85Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 52Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 25Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 52Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 68Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 78Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 60Hetal Patel, M.D., Part D claim volume, percentile in specialty: 39 · MIPS quality, percentile: 16
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 average

NPI registry status

Active

Issued 05/25/2011

NPI 1851684617

Primary specialty

Otolaryngology Physician

Mid-sized

11,060 US NPIs in this specialty

Medicare Part D claims

300 44% vs specialty avg

2024 prescription claims

Specialty avg: 536

MIPS final score

71.8/100 11.7 pts vs avg

Mid-tier band

vs 83.5 national avg

Specialty distribution in Illinois

How Otolaryngology Physician compares to other specialties among Illinois providers

Illinois providers
Clinical Social Worker5.2%Physical Therapist4.9%Mental Health Counselor4.5%Speech-Language Pathologist4.2%Student in an Organized Heal…4.1%Pharmacist4.1%Otolaryngology Physician0.2%
Largest specialties in Illinois (% of in-state providers)

Medicare quality performance, MIPS

Hetal Patel, M.D.'s 2023 MIPS final score plotted against the Otolaryngology Physician national average

Below national average
MIPS Final Score
71.8/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%71.8%
MIPS final score (Otolaryngology Physician) - 71.8/100 vs national avg 83.5
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).

Practice Address

7301 KNOXVILLE AVE
Peoria, IL 61614
(309) 589-5900

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
Measured-score avg: 83.5
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 · Typical

Hetal Patel, M.D. - brand share 11.0%
Otolaryngology Physician average

11% brand-name claims vs 89% generic, on 300 2024 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 2024.

300
Total Claims
$63K
Total Drug Cost
142
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
425.2
Total Day Supply
9,953
Brand vs Generic
11% brand / 89% generic
Brand Drug Cost
$54K
Generic Drug Cost
$9K
Opioid Claims
28 (9.3% rate)
Antibiotic Claims
36

Patient Demographics

Average Patient Age
73.0 years
Avg HCC Risk Score
1.20
Gender Split
55% female / 45% male
Age Distribution
<65: 13, 65-74: 68, 75-84: 43, 85+: 18

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.

What Hetal Patel, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2024

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2024
Drug Claims
Fluticasone Propionate
 63
Ipratropium Bromide
 33
Amoxicillin-Clavulanate Potass
Amoxicillin/Potassium Clav
30
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
25
Fluocinolone Acetonide Oil
 19
Omeprazole
 18
Dupixent Pen
Dupilumab
14
Ciprofloxacin-Dexamethasone
Ciprofloxacin Hcl/Dexameth
13
Ofloxacin
 11

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

More Otolaryngology Physician in IL → All providers in Illinois → Compare specialties →

Otolaryngology Physician Overview

How Hetal Patel, M.D. fits within the Otolaryngology Physician landscape nationally.

11,060
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
536
Avg Claims per Provider

Hetal Patel, M.D.'s 300 claims are below the specialty average of 536.

Nationwide Otolaryngology Physician peers with similar MIPS or enrollment year

Two federal-record peer sets for Patel, both outside Illinois so the neighborhoods are not geographic containment.

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (71.8 here).

Craig Bollig 71.8 PA Thomas Chung 71.8 CA John Gniady 71.8 PA David Goldenberg 71.8 PA

Same NPPES enumeration year (2011)

Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.

Thomas Fissenden Greeley, CO Shethal Bearelly Tucson, AZ Ryan George Fort Benning, GA Karthik Rajasekaran Philadelphia, PA

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.

One of 455 Otolaryngology Physician providers enrolled in Illinois, 5 are shown here.

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 →

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 2024, Hetal Patel, M.D. wrote 300 Medicare Part D claims totaling $63K in drug costs for 142 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 average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. 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 11% brand-name and 89% generic drugs by claim count, with $54K in brand drug costs.
Does Hetal Patel, M.D. prescribe opioids? ▼
Yes, Hetal Patel, M.D. had 28 opioid claims in 2024 with an opioid prescribing rate of 9.3%.
How many Otolaryngology Physician providers are there in the US? ▼
There are 11,060 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 536 Medicare Part D claims per year.
What drugs does Hetal Patel, M.D. prescribe most often? ▼
Based on 2024 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 300 Part D claims and 142 Medicare beneficiaries in 2024. 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 (2024). 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 August 2026 (NPPES) / 2024 (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 editorial process.

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 August 2026.