DR. VIRAL PATEL D.O. NPI 1003012428

Family Medicine in Crittenden, KY

NPI 1003012428 Individual Male Years of Experience 18 Family Medicine PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About VIRAL PATEL

Viral Patel is a primary care provider established in Crittenden, Kentucky and his medical specialization is family medicine with more than 18 years of experience. He graduated from University Of Pikeville, Kentucky College Of Osteopathic Med in 2004. The NPI number of Viral Patel is 1003012428 and was assigned on June 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 03024 (KY). The provider is registered as an individual and his NPI record was last updated September 2021.

A primary care provider (PCP) like Dr. Viral Patel D.o. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Viral Patel is enrolled in PECOS and is eligible to order or refer healthcare 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

Viral Patel is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with St Elizabeth Edgewood, St Elizabeth Grant and St Elizabeth Florence.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: colorectal cancer screening, medication reconciliation post-discharge, medication reconciliation post-discharge, pneumococcal vaccination status for older adults, preventive care and screening: body mass index (bmi) screening and follow-up plan and preventive care and screening: screening for depression and follow-up plan. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1003012428

Provider NameDR. VIRAL PATEL D.O.
Provider Location Address405 VIOLET RD CRITTENDEN, KY 41030
Provider Mailing AddressPO BOX 635283 CINCINNATI, OH 45263
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF PIKEVILLE, KENTUCKY COLLEGE OF OSTEOPATHIC MED
Graduation Year2004
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-22-2007
Last Update Date09-23-2021


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.03024
License StateKY
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

DR. VIRAL PATEL D.O.
405 VIOLET RD
CRITTENDEN, KY
ZIP 41030
Phone: (859) 428-1610
Fax: (859) 428-3923

Get Directions


Mailing Address

DR. VIRAL PATEL D.O.
PO BOX 635283
CINCINNATI, OH
ZIP 45263
Phone: (859) 428-1610
Fax: (859) 428-3923



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID8325148158
PECOS Enrollment IDI20070710000284
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 298Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 178Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • 95Administration of influenza virus vaccine (HCPCS:G0008)
  • 67Automated urinalysis test (HCPCS:81003)
  • 27Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 24Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple (HCPCS:G0180)
  • 15Administration of pneumococcal vaccine (HCPCS:G0009)
  • 12Pneumococcal vaccine for injection into muscle (HCPCS:90670)

Quality Reporting

The following quality measures meets Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Rate Number of Patients
Colorectal Cancer Screening 78% 209
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Medication Reconciliation Post-Discharge 100% 49
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing practitioner, registered nurse, or clinical pharmacist providing on-going care for whom the discharge medication list was reconciled with the current medication list in the outpatient medical record. This measure is reported as three rates stratified by age group: - Submission Criteria 1: 18-64 years of age - Submission Criteria 2: 65 years and older - Total Rate: All patients 18 years of age and older
Medication Reconciliation Post-Discharge 100% 54
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing practitioner, registered nurse, or clinical pharmacist providing on-going care for whom the discharge medication list was reconciled with the current medication list in the outpatient medical record. This measure is reported as three rates stratified by age group: - Submission Criteria 1: 18-64 years of age - Submission Criteria 2: 65 years and older - Total Rate: All patients 18 years of age and older
Pneumococcal Vaccination Status for Older Adults 87% 211
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 19% 308
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 54% 226
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Viral Patel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ST ELIZABETH EDGEWOOD1 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017
(859) 301-2000Acute Care Hospitals180035
ST ELIZABETH GRANT238 BARNES ROAD
WILLIAMSTOWN, KY 41097
(859) 824-8105Critical Access Hospitals181311
ST ELIZABETH FLORENCE4900 HOUSTON ROAD
FLORENCE, KY 41042
(859) 212-5220Acute Care Hospitals180045

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
2769277MEDICAID (05)OH
7100013990MEDICAID (05)KY

Other Providers at the same location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1952415788 OSCAR O PEREZ JR. DO
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1356446447DR. PHILLIP LEE KISER M.D.
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 903-0268
1891197273 RYAN FREIBERT D.O.
Individual
Neuromusculoskeletal Medicine & OMM405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1063895522 NICOLE ABBOT MD
Individual
Psychiatry & Neurology (Psychiatry)405 VIOLET RD
CRITTENDEN, KY 41030
(859) 301-5901
1780063636 ANDREA CLAIR GIST M.D.
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 903-0268
1053967653 AVERY JEA MARTIN
Individual
Nurse Practitioner405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1750899142 WILLIAM TRAVIS YOUNG ARNP, FNP-C
Individual
Nurse Practitioner405 VIOLET RD
CRITTENDEN, KY 41030
(859) 903-0268
1891285938HEALTHPOINT FAMILY CARE, INC.
Organization
Clinic/Center (Federally Qualified Health Center (FQHC))405 VIOLET RD
CRITTENDEN, KY 41030
(859) 655-6100
1518989334DR. KATHIE E MORGAN MD
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1942261250DR. BRADFORD ALAN QUATKEMEYER MD
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.