DR. PALAKKUMAR KANTILAL PATEL M.D.
NPI 1053559427
Internal Medicine in Toms River, NJ

Q: What is Palakkumar Patel's NPI number?

The NPI number for Palakkumar Patel is 1053559427. It was assigned to this individual provider in the NPPES registry on January 23, 2009.

Q: What is Palakkumar Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Palakkumar Patel was last updated on July 21, 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 January 23, 2009PECOS EnrolledAccepts Medicare Assignment

662 COMMONS WAY BLDG I4, TOMS RIVER, NJ 08755(732) 279-3681(732) 279-6043 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Mar 20, 2017 and 2 more (5 updates tracked since 2016).

On this page

About Dr. Palakkumar Kantilal Patel M.d. NPPES

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

DR. PALAKKUMAR KANTILAL PATEL M.D. (NPI 1053559427) is an individual internal medicine provider in Toms River, New Jersey, licensed in New Jersey (25MA09556300) and active in the NPI registry since January 2009. He is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and maintains a secondary practice location in Toms River.

NPPES Registry Identity

NPI1053559427

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. PALAKKUMAR KANTILAL PATELCredential: M.D.

Location Address662 COMMONS WAY BLDG I4Toms River, NJ 08755-6431

Mailing Address662 Commons Way Bldg I4Toms River, NJ 08755-6431 · (732) 279-3681 · Fax (732) 279-6043

Phone(732) 279-3681

Fax(732) 279-6043

Sole ProprietorYes

Medical School CMSOtherGraduated 2003

Enumeration DateJanuary 23, 2009

Last NPPES UpdateJuly 21, 20225 updates tracked since enumeration

✔ NPI 1053559427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in NJ · 25MA09556300✔ Licensed in PA · MD437785

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 25MA09556300 (NJ)

662 COMMONS WAY BLDG I4, Toms River, NJ 08755

Open in Google Maps ↗

Secondary Practice Location 1

Location 1780 ROUTE 37 W, STE 220TOMS RIVER, NJ 08755-5059 · Phone (732) 279-3681 · Fax (732) 279-6043

Other Identifiers 3

Medicaid0448664NJ

Medicaid102341647PA

Medicaid03133479NY

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. Palakkumar Kantilal 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 ID7517012446

PECOS Enrollment IDI20150211000266

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 15

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.

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.

544 services128 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.

342 services139 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

254 services22 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

162 services23 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

124 services22 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

111 services102 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

102 services18 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.

96 services59 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.

91 services85 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.

78 services55 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

38 services38 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.

28 services25 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

27 services27 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.

25 services25 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

25 services25 patients

Hospital Affiliations CMS Care Compare

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

Community Medical Center

Acute Care Hospitals · Toms River, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310041

Location99 Rt 37 WestToms River, NJ 08755 · Ocean County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08755 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

$140.34 typical visit price

range $61.59 – $185.05

Typical copayment $35.08 (range $15.39 – $46.26)

Most-billed visit code 99204

Established Patient

$107.94 typical visit price

range $20.08 – $150.98

Typical copayment $26.98 (range $5.02 – $37.74)

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

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.

100%1,137 patients5/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

37%126 patients2/55-star benchmark: 100%

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.

Other Providers at the Same Location NPPES

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

LIFELINE PRIMARY CARE LLC

Clinic/Center (Primary Care)

662 COMMONS WAY BLDG I4
TOMS RIVER, NJ 08755

Ocean County (732) 279-3681

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 Palakkumar Patel's NPI number?

The NPI number for Palakkumar Patel is 1053559427. It was assigned to this individual provider in the NPPES registry on January 23, 2009.

Where is Palakkumar Patel located?

Palakkumar Patel practices at 662 Commons Way Bldg I4, Toms River, NJ 08755. The listed phone number is (732) 279-3681.

What is Palakkumar Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Palakkumar Patel enrolled in Medicare?

Yes. Palakkumar 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 Palakkumar Patel affiliated with any hospitals?

According to CMS data, Palakkumar Patel is affiliated with Community Medical Center.

When was this NPI record last updated?

The NPPES record for Palakkumar Patel was last updated on July 21, 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.