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HIRALI PATEL OD
NPI 1003420852
Optometrist in Rockaway, NJ

Active since August 31, 2020PECOS EnrolledAccepts Medicare Assignment
343 MOUNT HOPE AVE STE 2, ROCKAWAY, NJ 07866(973) 366-8144 Get Directions Write a Review

NPPES record last updated: May 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 14, 2021, Oct 3, 2020, Sep 2, 2020 (3 updates tracked since 2020).

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

NPI1003420852
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameHIRALI PATELCredential: OD
Location Address343 MOUNT HOPE AVE STE 2Rockaway, NJ 07866-1644
Mailing Address343 Mount Hope Ave Ste 2Rockaway, NJ 07866-1644 · (973) 366-8144
Phone(973) 366-8144
Sole ProprietorNo
Medical School CMSState University Of New York - State College OptometryGraduated 2020
Enumeration DateAugust 31, 2020
Last NPPES UpdateMay 14, 20213 updates tracked since enumeration
NPPES CertifiedApril 20, 2021
✔ NPI 1003420852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in NJ · 27OA00698900
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
343 MOUNT HOPE AVE STE 2, Rockaway, NJ 07866
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Secondary Practice Locations 2

Location 110 North Village Blvd., Suite BSparta, NJ 07871 · Phone (073) 729-1181
Location 21655 Oak Tree RdEdison, NJ 08820-2858 · Phone (732) 494-8484

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Blue Cross and Blue Shield of Louisiana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID6901224815
PECOS Enrollment IDI20200915000851
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
137 services133 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
94 services93 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
38 services38 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
27 services24 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
19 services16 patients

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.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. RAQUEL ANTOINE OD
Optometrist
343 MOUNT HOPE AVE STE 2
ROCKAWAY, NJ 07866
Morris County (973) 366-1181
S P EYE CARE OF ROCKAWAY LLC
Clinic/Center (Health Service)
343 MOUNT HOPE AVE STE 2
ROCKAWAY, NJ 07866
Morris County (973) 366-8144

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.

What insurance does Hirali Patel accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 2 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.