NAINESH M PATEL MD
NPI 1043290372
Internal Medicine - Cardiovascular Disease in Pottstown, PA

Q: What is Nainesh Patel's NPI number?

The NPI number for Nainesh Patel is 1043290372. It was assigned to this individual provider in the NPPES registry on January 20, 2006.

Q: What is Nainesh Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Nainesh Patel was last updated on December 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 January 20, 2006PECOS EnrolledAccepts Medicare Assignment

94.74/100

CMS Quality Rating

1591 MEDICAL DR, POTTSTOWN, PA 19464(610) 326-8005(610) 718-0788 Get Directions Write a Review

NPPES record last updated: December 17, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 17, 2019, Jul 13, 2016 (2 updates tracked since 2016).

On this page

About Nainesh M Patel Md NPPES

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

NAINESH M PATEL MD (NPI 1043290372) is an individual cardiovascular disease provider in Pottstown, Pennsylvania, licensed in Pennsylvania (MD044234E) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1043290372

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameNAINESH M PATELCredential: MD

Location Address1591 MEDICAL DRPottstown, PA 19464-3224

Mailing Address1601 Medical DrPottstown, PA 19464-3241 · (610) 327-4200 · Fax (610) 327-8160

Phone(610) 326-8005

Fax(610) 718-0788

Sole ProprietorNo

Medical School CMSOtherGraduated 1982

Enumeration DateJanuary 20, 2006

Last NPPES UpdateDecember 17, 20192 updates tracked since enumeration

✔ NPI 1043290372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in PA · MD044234E

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1591 MEDICAL DR, Pottstown, PA 19464

Open in Google Maps ↗

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nainesh M Patel Md 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 ID749370674

PECOS Enrollment IDI20090115000531

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 23

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

1,193 services856 patients

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.

822 services663 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.

818 services779 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

506 services497 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

189 services177 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

150 services89 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

124 services83 patients

Programming of dual lead pacemaker system 93280

Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.

120 services92 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

105 services105 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

105 services105 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

87 services87 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.

81 services81 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

75 services75 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.

59 services59 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

46 services44 patients

Programming of multiple lead implantable defibrillator system 93284

Programming of a multiple lead implantable defibrillator system involves adjusting settings on your implanted device to help control irregular heart rhythms. The process is non-invasive and helps ensure optimal device performance for maintaining heart health.

37 services30 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

29 services28 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.

21 services21 patients

Programming of dual lead implantable defibrillator system 93283

Programming of a dual lead implantable defibrillator system involves adjusting settings on a device implanted in your chest. This device monitors your heart rhythm and delivers electrical pulses to correct irregular heartbeats, helping maintain a healthy heart rhythm.

20 services14 patients

Programming of multiple lead pacemaker system 93281

Programming of a multiple lead pacemaker system involves adjusting settings on your pacemaker device to optimize its function. This device uses electrical impulses to regulate your heart's rhythm. The procedure ensures it's working effectively for your specific needs.

19 services18 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

17 services17 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

15 services15 patients

External shock to heart to regulate heart beat 92960

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

13 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Reading Hospital

Acute Care Hospitals · West Reading, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390044

Location420 S 5th AvenueWest Reading, PA 19611 · Berks 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

Pottstown Hospital

Acute Care Hospitals · Pottstown, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390123

Location1600 East High StreetPottstown, PA 19464 · Montgomery County

Emergency services

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19464 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

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

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.

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.

94.74/100

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

Scored as part of a group practice

Quality

98.58

Promoting Interoperability

Improvement Activities

Cost

85.55

Other Providers at the Same Location NPPES 19

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

POTTSTOWN HOSPITAL COMPANY LLC

Clinic/Center (Ambulatory Surgical)