Providers
All 13 in IL
PURVI S PATEL, FNP
NPI 1881097244, individual, Rockford, IL, Nurse Practitioner, Family
5
Evidence tier
informational
- Medicaid dollars per patient on code 99202 ($421 per patient-month) sit in the top 5% of every provider billing that code.
score 35 of 100, rank 10205, $644K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PURVI S PATEL, FNP |
| Type | Individual |
| Status | Active |
| NPI issued | September 30, 2014, last updated September 30, 2014 |
| Practice location | 2222 E STATE ST, SUITE 209, Rockford, IL 61104-1573, 815-988-8500 |
| Specialties | Nurse Practitioner, Family (363LF0000X, primary, license 209011882 IL) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $1.1M | 73% | $421 | $45 (top 5% from $138) | 100th percentile | |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $159K | 11% | $30 | $21 (top 5% from $84) | 69th percentile | |
| 99205 | New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | $141K | 9% | $314 | $128 (top 5% from $249) | too few months to rank | |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | $85K | 6% | $46 | $30 (top 5% from $134) | 69th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $12K | 1% | $444 | $44 (top 5% from $110) | too few months to rank | |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | $5K | 0% | $151 | $37 (top 5% from $100) | too few months to rank | |
| 99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | $4K | 0% | $86 | $79 (top 5% from $359) | too few months to rank | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $3K | 0% | $212 | $88 (top 5% from $210) | too few months to rank |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 669 | 145 | $53K | $194 | $109 | 1.8x | 2.0x (90th percentile 3.4x) |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 367 | 133 | $45K | $306 | $158 | 1.9x | 1.9x (90th percentile 3.3x) |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 436 | 147 | $44K | $236 | $134 | 1.8x | 2.0x (90th percentile 3.4x) |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 441 | 133 | $29K | $149 | $93 | 1.6x | 2.0x (90th percentile 3.3x) |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | 70 | 70 | $8K | $278 | $158 | 1.8x | 1.9x (90th percentile 3.1x) |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 44 | 44 | $6K | $356 | $175 | 2.0x | 1.9x (90th percentile 3.1x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 21 | 20 | $2K | $268 | $113 | 2.4x | 2.3x (90th percentile 3.8x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
13 providers in Winnebago County, IL carry an indicator in the public record, with $4.3M at stake between them. The most common is part of a provider network, on 7 of them, followed by more hours than a day holds on 5. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | MERCYHEALTH VISITING NURSES ASSOCIATION, INC. Machesney Park, IL, ranked 327 | $5K |
|
| 3 | SWEDISHAMERICAN HOSPITAL Rockford, IL, ranked 813 | $157K |
|
| 3 | FAIR OAKS REHABILITATION AND HEALTH CARE CENTER, LLC South Beloit, IL, ranked 3192 | $0 |
|
| 3 | PRESENCE LIFE CONNECTIONS Rockford, IL, ranked 3537 | $0 |
|
| 3 | EAST BANK CENTER LLC Loves Park, IL, ranked 4010 | $0 |
|
| 3 | MEDINA NURSING CENTER, INC Durand, IL, ranked 4528 | $0 |
|
| 3 | ALPINE FIRESIDE HEALTH CENTER LTD Rockford, IL, ranked 5800 | $0 |
|
| 3 | MO CHARA HOSPICE LLC Cherry Valley, IL, ranked 6933 | $0 |
|
Recent enforcement in IL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 23, 2026
United States Attorney Andrew S. Boutros Announces Charges Against Two Chicago-Area Defendants as Part of Department of Justice’s National Healthcare Fraud Takedown
Two Chicago-area defendants were charged, one for selling Medicare beneficiary information and providing fake AI-generated consent recordings so laboratories could bill Medicare for over-the-counter Covid-19 test kits that were never requested or provided, and the other for directing the creation of fake medical records and billing Illinois Medicaid for behavioral health counseling and therapy services that were never provided, including for deceased beneficiaries.
DOJConvictedJun 18, 2026
Suburban Chicago Chiropractor Convicted of Healthcare Fraud
A chiropractor submitted fraudulent claims to Blue Cross Blue Shield of Illinois for health care services that were not actually provided and submitted false patient medical records when the insurer attempted to audit the claims.
DOJSentencedJun 10, 2026
Jacksonville Chiropractor Sentenced to a Year in Prison for Healthcare Fraud and Related Offenses
Rondeau submitted more than 2,000 fraudulent claims to health insurance companies and convinced clients to sign false documents after learning he was under investigation.
DOJCivil settlementMay 8, 2026
Three Affiliated Skilled Nursing Facilities to Pay $300,000 to Resolve False Claims Act Allegations Related to Medically Unnecessary Rehabilitation Services
Three affiliated skilled nursing facilities billed Medicare between Jan. 1, 2014, and Sept. 30, 2019, for physical therapy, occupational therapy, and speech pathology services provided to patients for longer than medically necessary and without regard for patients' individual medical needs, resulting in claims based on inflated RUG levels.
DOJIndictedFeb 12, 2026
Two Foreign Nationals Indicted in Chicago as Part of $10 Million Health Care Fraud Scheme
The indictment alleges the defendants used nominee-owned laboratories and durable medical equipment providers to submit fraudulent claims to Medicare and private health care benefit programs for items and services that were not provided, and laundered and transferred proceeds to Pakistan.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.