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PRIYA PATEL M.D.
NPI 1043698749
Ophthalmology in New York, NY

Active since May 13, 2015PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
550 1ST AVE, NEW YORK, NY 10016(212) 263-5506 Get Directions Write a Review

NPPES record last updated: July 26, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 26, 2019, Jun 23, 2016 (2 updates tracked since 2016).

About Priya Patel M.d. NPPES

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

PRIYA PATEL M.D. (NPI 1043698749) is an individual ophthalmology provider in New York, New York, licensed in Georgia (83532) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1043698749
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NamePRIYA PATELCredential: M.D.
Location Address550 1ST AVENew York, NY 10016-6402
Mailing Address10 Rappleye CtWest Orange, NJ 07052-2194
Phone(212) 263-5506
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 13, 2015
Last NPPES UpdateJuly 26, 20192 updates tracked since enumeration
✔ NPI 1043698749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in GA · 83532
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
550 1ST AVE, New York, NY 10016
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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

Priya 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 ID5799079398
PECOS Enrollment IDI20190812003092
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 9

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 problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
155 services82 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
148 services95 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
130 services80 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.
117 services117 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
50 services49 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.
47 services40 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10016 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
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Other Providers at the Same Location NPPES 20

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

DR. SHARON URALIL D.O.
Internal Medicine
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-3293
DR. DIANA TREVAS FLEISHER
Emergency Medicine (Pediatric Emergency Medicine)
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-3293
DR. MONICA GUPTA M.D.
Allergy & Immunology
550 1ST AVE, NBV 16N30, INTERNAL MEDICINE RESIDENCY PROGRAM
NEW YORK, NY 10016
New York County (212) 263-6397
CHRISTINE CHAN M.D.
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-5506
DR. MATTHEW CHIARELLO MD
Radiology (Vascular & Interventional Radiology)
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-5506
DR. MEGAN ELIZABETH JENKINS M.D.
Surgery
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-7300
DR. MANAN PATEL M.D.
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-5506
VICKY CHIANG
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
New York County (212) 263-5506

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 Priya Patel's NPI number?

The NPI number for Priya Patel is 1043698749. It was assigned to this individual provider in the NPPES registry on May 13, 2015.

Where is Priya Patel located?

Priya Patel practices at 550 1st Ave, New York, NY 10016. The listed phone number is (212) 263-5506.

What is Priya Patel's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Priya Patel enrolled in Medicare?

Yes. Priya 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 Priya Patel accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Priya 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 Priya Patel was last updated on July 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.