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DR. AJAY PATEL M.D.
NPI 1023078912
Internal Medicine in Saint Albans, WV

Active since March 24, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 51D0983207 · Microscopy
450 2ND ST, SAINT ALBANS, WV 25177(304) 727-0016(304) 727-2929 Get Directions Write a Review

NPPES record last updated: September 22, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Ajay Patel M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AJAY PATEL M.D. (NPI 1023078912) is an individual internal medicine provider in Saint Albans, West Virginia, licensed in West Virginia (20391) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, holds a CLIA Microscopy certificate valid through February 19, 2027, and is affiliated with Charleston Area Medical Center.

NPPES Registry Identity

NPI1023078912
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. AJAY PATELCredential: M.D.
Location Address450 2ND STSaint Albans, WV 25177-2857
Mailing Address450 2nd StSaint Albans, WV 25177-2857 · (304) 727-0016 · Fax (304) 727-2929
Phone(304) 727-0016
Fax(304) 727-2929
Sole ProprietorYes
Medical School CMSOtherGraduated 1987
Enumeration DateMarch 24, 2006
Last NPPES UpdateSeptember 22, 2010
✔ NPI 1023078912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WV · 20391
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
450 2ND ST, Saint Albans, WV 25177
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Other Identifiers 3

Medicare ID-Type Unspecified4040422WV
Medicaid1804439000WV
Medicare UPING13539WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.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

Dr. Ajay Patel M.d. 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 ID8123082666
PECOS Enrollment IDI20041116000248
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 51D0983207

Ajay T Patel MD · Saint Albans, WV
Active · expires Feb 19, 2027
CLIA Number51D0983207
Laboratory TypePhysician Office
Certificate Effective DateFebruary 20, 2025
Certificate Expiration DateFebruary 19, 2027
Laboratory DirectorAjay T. Patel MD
Laboratory Phone(304) 727-0016
Laboratory LocationAjay T Patel MD450 2nd Street, Saint Albans, WV 25177
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Areas of Expertise CMS Part B claims 15

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
191 services50 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.
189 services42 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
77 services27 patients
Face-to-face behavioral counseling for obesity, 15 minutes G0447
This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.
71 services17 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
62 services23 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
53 services44 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Charleston Area Medical Center

Acute Care Hospitals · Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510022
Location501 Morris StreetCharleston, WV 25301 · Kanawha County
Emergency services Birthing friendly

Thomas Memorial Hospital

Acute Care Hospitals · South Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510029
Location4605 Maccorkle Avenue SWSouth Charleston, WV 25309 · Kanawha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25177 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
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
46%136 patients3/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
56%190 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
82%312 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
58%129 patients3/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
65%129 patients3/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
61%129 patients3/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
94%626 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%2,045 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
92%213 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
53%30 patients1/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
46%426 patients2/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
86%213 patients4/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
97%626 patients5/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
63%556 patients3/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
99%426 patients4/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 100% · 199 patients
97%199 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
3 suppliers15 claims18 services$6.62 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AJAY T PATEL MD INC
Internal Medicine
450 2ND ST
SAINT ALBANS, WV 25177
Kanawha County (304) 727-0016

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 Ajay Patel's NPI number?

The NPI number for Ajay Patel is 1023078912. It was assigned to this individual provider in the NPPES registry on March 24, 2006.

Where is Ajay Patel located?

Ajay Patel practices at 450 2nd St, Saint Albans, WV 25177. The listed phone number is (304) 727-0016.

What is Ajay Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ajay Patel enrolled in Medicare?

Yes. Ajay 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.

Does Ajay Patel hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 51D0983207) is associated with this NPI, valid through February 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ajay Patel accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Ajay 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.

Is Ajay Patel affiliated with any hospitals?

According to CMS data, Ajay Patel is affiliated with Charleston Area Medical Center and Thomas Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Ajay Patel was last updated on September 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.