Physician

Nirav Nagarsheth

According to 2025 Medicare claims, Nirav Nagarsheth (NPI: 1457858318) practices rheumatology in the Lake County, IL market, with the plurality of this provider's patient population coming from Lake, IL. This provider's primary affiliated billing organization is ILLINOIS BONE AND JOINT INSTITUTE LLC (NPI: 1205922432; TIN: 20-3845479) and primary practice location at 60031-3399.

Nagarsheth's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 245 traditional Medicare patients, billed 21,423 HCPCS/CPT codes, and received $308,818 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 1,520 prescription claims across 227 beneficiaries totaling $1,200,366 in drug costs, led by Krystexxa (Pegloticase). Open Payments data shows 147 records totaling $3,235. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider has fewer than 5 years of reported Medicare Part B carrier billing data, so a reliable trend cannot be assigned. Concurrently, Part D prescription costs have moved sharply higher in recent years, from $11,962 to $1,200,366. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Part B Carrier Billing Trend. X-axis: year 2015-2024. Y-axis: Medicare payment, unit: USD. Field: Tot_Mdcr_Pymt_Amt. Source: Medicare Physician & Other Practitioners by Provider.0$154K$309K2023 Medicare payment: $40,077 (USD; Tot_Mdcr_Pymt_Amt)2024 Medicare payment: $308,818 (USD; Tot_Mdcr_Pymt_Amt)2015201620172018201920202021202220232024
YearPatientsClm LinesPayment
2015N/RN/RN/R
2016N/RN/RN/R
2017N/RN/RN/R
2018N/RN/RN/R
2019N/RN/RN/R
2020N/RN/RN/R
2021N/RN/RN/R
2022N/RN/RN/R
2023681,826$40,077
202424521,423$308,818

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Part D Events Trend. X-axis: year 2015-2024. Y-axis: Drug cost, unit: USD. Field: Tot_Drug_Cst. Source: Medicare Part D Prescribers by Provider.0$600K$1.2M2018 Drug cost: $11,962 (USD; Tot_Drug_Cst)2019 Drug cost: $8,721 (USD; Tot_Drug_Cst)2020 Drug cost: $4,840 (USD; Tot_Drug_Cst)2021 Drug cost: $19,109 (USD; Tot_Drug_Cst)2022 Drug cost: $145,242 (USD; Tot_Drug_Cst)2023 Drug cost: $307,379 (USD; Tot_Drug_Cst)2024 Drug cost: $1,200,366 (USD; Tot_Drug_Cst)2015201620172018201920202021202220232024
YearPatientsClaimsDrug Cost
2015N/RN/RN/R
2016N/RN/RN/R
2017N/RN/RN/R
20182357$11,962
20193073$8,721
20203065$4,840
20213685$19,109
202233168$145,242
202391316$307,379
20242271,520$1,200,366

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

No connected DME records

No connected DME records

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

CodeDescriptionPatientsClm LinesTotal Payment
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more136136$122
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more182457$98
77080Dxa bone density measurement of hip, pelvis, spine7777$39
77089Calculation of trabecular bone score (tbs) using imaging data with interpretation and report on fracture risk5858$31
G2211Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's155311$13

Top 5 Part D drugs in 2024

By total drug costs.

DrugGenericClaimsTotal Day SupplyTotal Drug Cost
KrystexxaPegloticase23322$596,710
Enbrel SureclickEtanercept22840$222,955
Humira(Cf) PenAdalimumab33924$220,691
LeflunomideLeflunomide965,719$4,346
MethotrexateMethotrexate Sodium21810,369$3,966

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

CategoryDefinitionRecordsTotal Reported AmountTop Related Entity
General PaymentsReported payment or transfer-of-value amount.147$3,235Amgen Inc.
Research PaymentsReported research-related payment or transfer-of-value amount.0$0N/R
Ownership / Investment InterestsReported value of ownership or investment interests.0$0N/R

FAQ

What Medicare data is available for Nirav Nagarsheth?

Tedicare shows public-source Medicare data for Nirav Nagarsheth (NPI 1457858318), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Nirav Nagarsheth have ACO affiliation data?

No ACO affiliation record is shown in the available Tedicare data for this profile.

What billing organization is linked to Nirav Nagarsheth?

Nirav Nagarsheth is linked to ILLINOIS BONE AND JOINT INSTITUTE LLC (billing NPI 1205922432) in the available physician profile data.

Does Nirav Nagarsheth have Open Payments data?

Nirav Nagarsheth has 147 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.