DR. NILESHKUMAR G. PATEL MD
NPI 1043316755
Family Medicine in Patchogue, NY

Active since September 16, 2006PECOS EnrolledAccepts Medicare Assignment
1 E ROE BLVD, PATCHOGUE MEDICAL GROUP,LLP, PATCHOGUE, NY 11772(631) 475-3900(631) 475-5166 Get Directions Write a Review

NPPES record last updated: October 11, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Nileshkumar G. Patel Md NPPES

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

DR. NILESHKUMAR G. PATEL MD (NPI 1043316755) is an individual family medicine provider in Patchogue, New York, licensed in New York (189692-1) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Long Island Community Hospital, and is a graduate of Other (1976).

NPPES Registry Identity

NPI1043316755
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. NILESHKUMAR G. PATELCredential: MD
Location Address1 E ROE BLVD, PATCHOGUE MEDICAL GROUP,LLPPatchogue, NY 11772-2631
Mailing Address1 E Roe Blvd, Patchogue Medical Group,llpPatchogue, NY 11772-2631 · (631) 475-3900 · Fax (631) 475-5166
Fax(631) 475-5166
Sole ProprietorNo
Medical School CMSOtherGraduated 1976
Enumeration DateSeptember 16, 2006
Last NPPES UpdateOctober 11, 2012
NPI 1043316755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NY · 189692-1
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1 E ROE BLVD, Patchogue, NY 11772

Other Identifiers 3

Medicaid01341120NY
Medicare UPINF30371NY
Medicare ID-Type Unspecified63K001NY

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. Nileshkumar G. 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 ID8325065295
PECOS Enrollment IDI20051031000107
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 45

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.
1,143 services313 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
498 services255 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
430 services240 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
429 services240 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
422 services239 patients
Iron level 83540
An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.
421 services239 patients

Hospital Affiliations CMS Care Compare

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

Long Island Community Hospital

Acute Care Hospitals · Patchogue, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330141
Location101 Hospital RoadPatchogue, NY 11772 · Suffolk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11772 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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
6%344 patients1/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
11%748 patients1/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 17% · 81 patients
Patients 4MonthsOfStart: 18% · 77 patients
44%78 patients
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
15%279 patients1/55-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
81%279 patients4/55-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
75%279 patients4/55-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.
89%5,786 patients3/55-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.
99%16,658 patients4/55-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
19%425 patients1/55-star benchmark: 99%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
66%1,616 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
68%425 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…
35%1,410 patients2/55-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
43%992 patients2/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
59%1,257 patients3/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 96% · 1,147 patients
Patients tobacco: 86% · 1,147 patients
51%255 patients3/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
94%1,616 patients4/55-star benchmark: 100%
Send a Summary of Care
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…
0%237 patients1/55-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+: 5% · 425 patients
11%425 patients2/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
2%1,616 patients
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 7

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
19 suppliers55 claims111 services$6.03 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers13 claims24 services$1.02 avg. paid by Medicare
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty E0181
DME-Other DME · category DE000N
1 supplier11 claims11 services$10.39 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers28 claims28 services$36.74 avg. paid by Medicare
Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038
DME-Other DME · category DE000N
1 supplier11 claims11 services$8.22 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier11 claims11 services$10.47 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 11

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

Podiatrist
1 E ROE BLVD, PATCHOGUE MEDICAL GROUP
PATCHOGUE, NY 11772
Allergy & Immunology
1 E ROE BLVD
PATCHOGUE, NY 11772
Durable Medical Equipment & Medical Supplies
1 E ROE BLVD
PATCHOGUE, NY 11772
Durable Medical Equipment & Medical Supplies
1 E ROE BLVD
PATCHOGUE, NY 11772
Internal Medicine
1 E ROE BLVD
PATCHOGUE, NY 11772
Internal Medicine
1 E ROE BLVD
PATCHOGUE, NY 11772
Internal Medicine (Cardiovascular Disease)
1 E ROE BLVD
PATCHOGUE, NY 11772
Nurse Practitioner (Adult Health)
1 E ROE BLVD
PATCHOGUE, NY 11772

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 Nileshkumar Patel's NPI number?

The NPI number for Nileshkumar Patel is 1043316755. It was assigned to this individual provider in the NPPES registry on September 16, 2006.

Where is Nileshkumar Patel located?

Nileshkumar Patel practices at 1 E Roe Blvd Patchogue Medical Group,llp, Patchogue, NY 11772. The listed phone number is (631) 475-3900.

What is Nileshkumar Patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Nileshkumar Patel enrolled in Medicare?

Yes. Nileshkumar 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.

Is Nileshkumar Patel affiliated with any hospitals?

According to CMS data, Nileshkumar Patel is affiliated with Long Island Community Hospital.

When was this NPI record last updated?

The NPPES record for Nileshkumar Patel was last updated on October 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.