VANDANKUMAR PATEL MD
NPI 1043743255
Internal Medicine - Pulmonary Disease in Newton, NJ

Q: What is Vandankumar Patel's NPI number?

The NPI number for Vandankumar Patel is 1043743255. It was assigned to this individual provider in the NPPES registry on April 5, 2017.

Q: What is Vandankumar Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Vandankumar Patel was last updated on October 24, 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 April 05, 2017PECOS EnrolledAccepts Medicare Assignment

175 HIGH ST, NEWTON, NJ 07860(973) 383-2121(973) 383-8973 Get Directions Write a Review

NPPES record last updated: October 24, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 24, 2022, Jul 13, 2022, Dec 6, 2021 (3 updates tracked since 2021).

On this page

About Vandankumar Patel Md NPPES

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

VANDANKUMAR PATEL MD (NPI 1043743255) is an individual pulmonary disease provider in Newton, New Jersey, licensed in New Jersey (25MA10899000) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Regional West Medical Center, and maintains a secondary practice location in Hackettstown.

NPPES Registry Identity

NPI1043743255

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameVANDANKUMAR PATELCredential: MD

Location Address175 HIGH STNewton, NJ 07860-1004

Mailing AddressPo Box 416457Boston, MA 02241-6457 · (844) 362-7495 · Fax (973) 290-7495

Phone(973) 383-2121

Fax(973) 383-8973

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateApril 5, 2017

Last NPPES UpdateOctober 24, 20223 updates tracked since enumeration

NPPES CertifiedOctober 24, 2022

✔ NPI 1043743255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in NJ · 25MA10899000✔ Licensed in KS · ET00308✔ Licensed in MO · 2021049034

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

175 HIGH ST, Newton, NJ 07860

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Secondary Practice Location 1

Location 1651 Willow Grove StHackettstown, NJ 07840-1799 · Phone (908) 852-5100 · Fax (908) 850-6822

Accepted Insurance

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

Vandankumar 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 ID8628468626

PECOS Enrollment IDI20221107002060, I20230824002113

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 Vandankumar Patel reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Practice Associates Medical Group

24 mi

Internal Medicine

100 MADISON AVENUE, INTEROFFICE #68
Morristown, NJ 07960

Reassigned Medicare billing, New Jersey enrollment
1,699 clinicians in this Medicare group

NPI 1427016385 (844) 264-2250

T J Samson Community Hospital

660 mi

Hospice and Palliative Medicine

1301 N RACE ST
Glasgow, KY 42141

Reassigned Medicare billing, Kentucky enrollment
323 clinicians in this Medicare group

NPI 1922343300 (270) 651-4430

Physician Specialists Of St Lukes LLC

852 mi

Internal Medicine

232 S WOODS MILL RD
Chesterfield, MO 63017

Reassigned Medicare billing, Missouri enrollment
215 clinicians in this Medicare group

NPI 1235168410 (314) 434-1500

Saint Luke's Physician Group Inc

1,040 mi

Infusion Therapy

600 NE ADAMS DAIRY PKWY
Blue Springs, MO 64014

Reassigned Medicare billing, Missouri enrollment
Medicare enrollment name: Saint Lukes Physician Group Inc
1,339 clinicians in this Medicare group

NPI 1376257220 (816) 932-4630

Panhandle Health Services

1,491 mi

Specialist

3911 AVENUE B STE 3400
Scottsbluff, NE 69361

Reassigned Medicare billing, Nebraska enrollment
Medicare enrollment name: Regional West Physicians Clinic
208 clinicians in this Medicare group

NPI 1114065216 (308) 635-8900

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 17

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

118 services37 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.

79 services63 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.

77 services77 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.

58 services58 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.

58 services25 patients

Test to measure largest amount of air breathed in an out 94200

This test, called spirometry, measures your lung capacity. It involves taking a deep breath and then exhaling as forcefully as possible into a machine. The results help assess how well your lungs function.

56 services56 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.

54 services45 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.

41 services41 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.

33 services33 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.

27 services13 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.

26 services26 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.

20 services20 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

18 services18 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.

14 services12 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.

14 services14 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.

12 services12 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.

12 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Regional West Medical Center

Acute Care Hospitals · Scottsbluff, NE

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number280061

Location4021 Ave BScottsbluff, NE 69361 · Scott Bluff County

Emergency services Birthing friendly

Box Butte General Hospital

Critical Access Hospitals · Alliance, NE

OwnershipGovernment - Local

CMS Certification Number281360

LocationP O Box 810, 2101 Box Butte AveAlliance, NE 69301 · Box Butte County

Emergency services

Newton Medical Center

Acute Care Hospitals · Newton, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310028

Location175 High StNewton, NJ 07860 · Sussex County

Emergency services Birthing friendly

Hackettstown Medical Center

Acute Care Hospitals · Hackettstown, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310115

Location651 Willow Grove StHackettstown, NJ 07840 · Warren County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07860 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

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.

ARADHANA AGGARWAL

Internal Medicine

175 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 383-2121

CHRISTINE KALAFUT PA-C

Physician Assistant (Medical)

175 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 383-0453

DR. HRISTO VASSILEV STOYTCHEV MD

Internal Medicine

175 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 383-2121

MARISA PARISE PETRUCELLI D.O.

Anesthesiology

175 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 383-2121

JEAN KAMALA MALLIPUDI MD

Internal Medicine

175 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 579-8321

NEWTON MEDICAL CENTER

Psychiatric Unit

175 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 579-8723

DR. DEVINA JAYESH ADALJA MD

Hospitalist

175 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 579-8321

SUSHMITHA DIRAVIAM MD

Hospitalist

175 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 579-8321

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 Vandankumar Patel's NPI number?

The NPI number for Vandankumar Patel is 1043743255. It was assigned to this individual provider in the NPPES registry on April 5, 2017.

Where is Vandankumar Patel located?

Vandankumar Patel practices at 175 High St, Newton, NJ 07860. The listed phone number is (973) 383-2121.

What is Vandankumar Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Vandankumar Patel enrolled in Medicare?

Yes. Vandankumar 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.

Which organizations bill Medicare for Vandankumar Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vandankumar Patel reassigns Medicare benefits to 5 organizations: Practice Associates Medical Group (Morristown, NJ), T J Samson Community Hospital (Glasgow, KY), Physician Specialists Of St Lukes LLC (Chesterfield, MO), Saint Luke's Physician Group Inc (Blue Springs, MO) and Panhandle Health Services (Scottsbluff, NE). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vandankumar Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Vandankumar Patel accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Kansas City and 4 other insurers list Vandankumar 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 Vandankumar Patel affiliated with any hospitals?

According to CMS data, Vandankumar Patel is affiliated with Regional West Medical Center, Box Butte General Hospital, Newton Medical Center and Hackettstown Medical Center.

When was this NPI record last updated?

The NPPES record for Vandankumar Patel was last updated on October 24, 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.