DR. HIRAL PATEL DO
NPI 1023137742
Internal Medicine - Sleep Medicine in Berwyn, PA

Q: What is Hiral Patel's NPI number?

The NPI number for Hiral Patel is 1023137742. It was assigned to this individual provider in the NPPES registry on March 28, 2007.

Q: What is Hiral Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Q: When was this NPI record last updated?

The NPPES record for Hiral Patel was last updated on July 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 28, 2007PECOS EnrolledAccepts Medicare Assignment

86.75/100

CMS Quality Rating

1001 CHESTERBROOK BLVD FL 3, BERWYN, PA 19312(610) 576-7600(610) 576-7705 Get Directions Write a Review

NPPES record last updated: July 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Hiral Patel Do NPPES

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

DR. HIRAL PATEL DO (NPI 1023137742) is an individual sleep medicine provider in Berwyn, Pennsylvania, licensed in Pennsylvania (OS012407) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with Lancaster General Hospital, and is a graduate of Philadelphia College Of Osteopathic Medicine (2001).

NPPES Registry Identity

NPI1023137742

Entity TypeIndividualFemale

Primary Taxonomy207RS0012X

Provider Legal NameDR. HIRAL PATELCredential: DO

Location Address1001 CHESTERBROOK BLVD FL 3Berwyn, PA 19312-3805

Mailing Address1001 Chesterbrook Blvd Fl 3Berwyn, PA 19312-3805 · (610) 576-7600 · Fax (610) 576-7705

Phone(610) 576-7600

Fax(610) 576-7705

Sole ProprietorNo

Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2001

Enumeration DateMarch 28, 2007

Last NPPES UpdateJuly 8, 2022

NPPES CertifiedJuly 8, 2022

✔ NPI 1023137742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RS0012X

License✔ Licensed in PA · OS012407

Definition

An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License OS012407 (PA)

1001 CHESTERBROOK BLVD FL 3, Berwyn, PA 19312

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Dr. Hiral Patel Do 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 ID6709970494

PECOS Enrollment IDI20070926000386

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.

Medicare Billing Reassignments

Medicare enrollment records show Hiral Patel reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Clinical Care Associates Of The University Of Pennsylvania Health

5.8 mi

Internal Medicine

250 KING OF PRUSSIA RD, 4TH FLOOR
Radnor, PA 19087

Reassigned Medicare billing, Pennsylvania enrollment
983 clinicians in this Medicare group

NPI 1972682995 (610) 902-1720

University Of Penn - Medical Group

16 mi

Nephrology

3737 MARKET ST FL 12
Philadelphia, PA 19104

Reassigned Medicare billing, Pennsylvania enrollment
289 clinicians in this Medicare group

NPI 1629181912 (215) 662-8730

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 11

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.

659 services388 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

339 services290 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

169 services169 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.

100 services91 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

98 services96 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

98 services96 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

81 services59 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

43 services43 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

39 services39 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

31 services31 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Lancaster General Hospital

Acute Care Hospitals · Lancaster, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390100

Location555 North Duke StreetLancaster, PA 17602 · Lancaster County

Emergency services Birthing friendly

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390111

Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County

Emergency services Birthing friendly

Phoenixville Hospital

Acute Care Hospitals · Phoenixville, PA

3/5 CMS rating

OwnershipProprietary

CMS Certification Number390127

Location140 Nutt RoadPhoenixville, PA 19460 · Chester County

Emergency services Birthing friendly

Paoli Hospital

Acute Care Hospitals · Paoli, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390153

Location255 West Lancaster AvenuePaoli, PA 19301 · Chester County

Emergency services Birthing friendly

Chester County Hospital

Acute Care Hospitals · West Chester, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390179

Location701 East Marshall StreetWest Chester, PA 19380 · Chester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19312 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

$137.17 typical visit price

range $59.88 – $180.99

Typical copayment $34.29 (range $14.97 – $45.24)

Most-billed visit code 99204

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

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.

86.75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

75.91

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 27

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

Tubing with integrated heating element for use with positive airway pressure device A4604