PAUL GILBERT MD
NPI 1154343358
Emergency Medicine in Chicago, IL
NPI Status: Active since July 24, 2006
Contact Information
57 E DELAWARE PL
3406
CHICAGO, IL
ZIP 60611
Phone: (312) 951-5800
- Individual
- Male
- Emergency Medicine
- Accepts Insurance
- PECOS Enrolled
About PAUL GILBERT
This page provides the complete NPI Profile along with additional information for Paul Gilbert, a provider established in Chicago, Illinois with a medical specialization in Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1154343358 assigned on July 2006. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1154343358
- Provider Name
- PAUL GILBERT MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 57 E DELAWARE PL 3406 CHICAGO, IL 60611
- Location Phone
- (312) 951-5800
- Mailing Address
- 57 E DELAWARE PL 3406 CHICAGO, IL 60611
- Mailing Phone
- (312) 951-5800
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-24-2006
- Last Update Date
- 11-16-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License State
- IL
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Imperial Preferred Gold - HMO
- Imperial Preferred Silver - HMO
- Imperial Standard Bronze - HMO
- Imperial Standard Gold - HMO
- Imperial Standard Silver - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 08232204 | OTHER (01) | IL | BLUE CROSS BLUE SHIELD |
| K44277 | MEDICARE PIN (08) | IL | |
| 0361083545 | MEDICAID (05) | IL | |
| H79245 | MEDICARE UPIN (02) | ||
| K45568 | MEDICARE UPIN (02) | IL |
Medicare Participation & PECOS Enrollment Status
Paul Gilbert is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Advance care planning, first 30 minutes
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
Assessment of and care planning for impaired thought processing, typically 50 minutes
Biopsy of related skin growth, first growth
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
Destruction of precancer skin growth, 1 growth
Destruction of precancer skin growth, 2-14 growths
Destruction of skin growth, 1-14 growths
Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of mild to moderate severity
Emergency department visit for problem of moderate severity
Established patient custodial care facility, group care, or assisted living visit, typically 1 hour
Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes
Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes
Established patient home visit, typically 1 hour
Established patient home visit, typically 40 minutes
New patient custodial care facility, group care, or assisted living visit, typically 1 hour
New patient custodial care facility, group care, or assisted living visit, typically 45 minutes
New patient custodial care facility, group care, or assisted living visit, typically 75 minutes
New patient home visit, typically 1 hour
New patient home visit, typically 45 minutes
New patient home visit, typically 75 minutes
Psychiatric diagnostic evaluation with medical services
Psychotherapy with evaluation and management visit, 30 minutes
Transitional care management services for problem of high complexity
Transitional care management services for problem of moderate complexity
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
This service was performed 31 times for 30 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 28 times for 28 patientsAn annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
This service was performed 14 times for 14 patientsThis service involves a thorough evaluation of your thought processes, which may be impacting your daily life. In a typical 50-minute session, a healthcare professional will assess your cognitive abilities, identify any areas of concern, and develop a personalized care plan to help improve your mental function.
This service was performed 14 times for 14 patientsA biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
This service was performed 18 times for 17 patientsThis service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.
This service was performed 134 times for 131 patients"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
This service was performed 111 times for 92 patientsThis procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
This service was performed 127 times for 46 patients"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
This service was performed 25 times for 23 patientsAn emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 12 times for 12 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 27 times for 26 patientsAn emergency department visit for a mild to moderate issue is when you seek immediate medical attention for a non-life-threatening condition. This could include minor injuries, moderate pain, or illnesses like the flu. During the visit, healthcare professionals assess your condition, provide treatment, and may recommend follow-up care.
This service was performed 15 times for 15 patientsAn emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
This service was performed 33 times for 32 patientsThis service involves a healthcare professional visiting an established patient in a group care facility or assisted living for about an hour. The visit may include health checks, medication management, and addressing any health concerns to maintain the patient's well-being.
This service was performed 1,598 times for 403 patientsThis refers to a routine medical visit for an established patient living in a group care facility, custodial care, or assisted living. The visit typically lasts 25 minutes and includes a check-up and discussion about ongoing healthcare needs.
This service was performed 53 times for 48 patientsThis is a routine visit for established patients residing in care facilities like nursing homes or assisted living. The visit typically lasts about 40 minutes, during which the healthcare provider checks your overall health, discusses any concerns, and adjusts care plans as needed.
This service was performed 497 times for 274 patientsAn established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
This service was performed 153 times for 78 patientsAn established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
This service was performed 141 times for 86 patientsThis service involves a one-hour visit for a new patient at a custodial care facility, group care home, or assisted living facility. During this time, a healthcare professional will assess the patient's health condition, discuss care plans, and address any concerns the patient may have.
This service was performed 90 times for 90 patientsThis service involves a medical professional visiting a new patient at a care facility or assisted living for about 45 minutes. During this visit, the professional will assess the patient's health, discuss any concerns, and plan for future care. This service aims to ensure the patient's well-being and comfort in their new environment.
This service was performed 15 times for 15 patientsThis service involves an initial visit to a new patient in a custodial care facility, group care, or assisted living. The visit typically lasts 75 minutes and focuses on assessing the patient's health status, understanding their needs, and planning their ongoing care.
This service was performed 99 times for 99 patientsA new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.
This service was performed 19 times for 19 patientsA new patient home visit is a service where a healthcare professional visits you at your home. This initial 45-minute appointment is for understanding your health history, current condition, and to discuss your healthcare needs. It's a convenient way to receive care without leaving your home.
This service was performed 13 times for 13 patientsA new patient home visit is a comprehensive 75-minute appointment conducted at your home. The healthcare professional will assess your health, discuss any concerns, and create a personalized care plan. It's convenient, comfortable, and tailored to your specific needs.
This service was performed 19 times for 19 patientsA psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
This service was performed 34 times for 34 patientsPsychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
This service was performed 98 times for 33 patientsTransitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
This service was performed 56 times for 50 patientsTransitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
This service was performed 13 times for 12 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 60611 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $94.06
- Minimum New Patient Price $60.08
- Maximum New Patient Price $183.39
- Average New Patient Copayment $23.51
- Minimum New Patient Copayment $15.02
- Maximum New Patient Copayment $45.84
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $105.7
- Minimum Established Patient Price $18.97
- Maximum Established Patient Price $148.12
- Average Established Patient Copayment $26.42
- Minimum Established Patient Copayment $4.74
- Maximum Established Patient Copayment $37.03
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 5 | 4 | 3 | 4 | 3 | 3 | 5 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 10 | 4 | 6 | 4 | 6 | 3 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 0 + 4 + 6 + 4 + 6 + 3 + 1 + 0 + 24 = 52 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 52 = 8 | 8 | ||||||||
The NPI number 1154343358 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154343358, enumerated in the NPI registry as an "individual" on July 24, 2006
The provider is located at 57 E Delaware Pl 3406 Chicago, Il 60611 and the phone number is (312) 951-5800
The provider's speciality is Emergency Medicine with taxonomy code 207P00000X
The provider might be accepting Accepts: Imperial Insurance Companies, Inc., Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $94.06 with an average copayment of $23.51 for new patient appointments. Established patients should expect a typical charge of $105.7 and an average copayment of 26.42. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Advance care planning, first 30 minutes, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit, Assessment of and care planning for impaired thought processing, typically 50 minutes, Biopsy of related skin growth, first growth, Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service), Destruction of precancer skin growth, 1 growth, Destruction of precancer skin growth, 2-14 growths, Destruction of skin growth, 1-14 growths, Emergency department visit for life threatening or functioning severity, Emergency department visit for problem of high severity, Emergency department visit for problem of mild to moderate severity, Emergency department visit for problem of moderate severity, Established patient custodial care facility, group care, or assisted living visit, typically 1 hour, Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes, Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes, Established patient home visit, typically 1 hour, Established patient home visit, typically 40 minutes, New patient custodial care facility, group care, or assisted living visit, typically 1 hour, New patient custodial care facility, group care, or assisted living visit, typically 45 minutes, New patient custodial care facility, group care, or assisted living visit, typically 75 minutes, New patient home visit, typically 1 hour, New patient home visit, typically 45 minutes, New patient home visit, typically 75 minutes, Psychiatric diagnostic evaluation with medical services, Psychotherapy with evaluation and management visit, 30 minutes, Transitional care management services for problem of high complexity and Transitional care management services for problem of moderate complexity.
This NPI record was last updated on July 24, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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