HIRALI PATEL OD
NPI 1003420852
Optometrist in Rockaway, NJ
About Hirali Patel Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HIRALI PATEL OD (NPI 1003420852) is an individual optometrist in Rockaway, New Jersey, licensed in New Jersey (27OA00698900) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of State University Of New York - State College Optometry (2020).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Hirali Patel Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Hirali Patel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sparta, NJ 07871
- Reassigned Medicare billing, New Jersey enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 07866 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROCKAWAY, NJ 07866
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Hirali Patel's NPI number?
The NPI number for Hirali Patel is 1003420852. It was assigned to this individual provider in the NPPES registry on August 31, 2020.
Where is Hirali Patel located?
Hirali Patel practices at 343 Mount Hope Ave Ste 2, Rockaway, NJ 07866. The listed phone number is (973) 366-8144.
What is Hirali Patel's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Hirali Patel enrolled in Medicare?
Yes. Hirali Patel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Hirali Patel's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Hirali Patel reassigns Medicare benefits to Peli Eyecare And Associates (Sparta, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hirali Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Hirali Patel accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 10 other insurers list Hirali Patel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Hirali Patel was last updated on May 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Hirali Patel, OD · NPI 1003420852
Optometrist provider in Rockaway, New Jersey. Individual provider, active in the CMS NPPES registry since August 31, 2020.
## Identity
- **NPI:** 1003420852 (Entity type: Individual)
- **Enumerated:** August 31, 2020
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 27OA00698900 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 343 MOUNT HOPE AVE STE 2, Rockaway, NJ 07866-1644
- **Phone:** (973) 366-8144
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Peli Eyecare And Associates (NPI 1679115836, Sparta, NJ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** State University Of New York - State College Optometry, class of 2020
## Record status
- **NPPES last updated:** May 14, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1003420852) · Data from the CMS NPPES public registry.