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KALPESH PATEL MD
NPI 1053572263
Internal Medicine - Interventional Cardiology in Plano, TX

Active since June 19, 2008PECOS EnrolledAccepts Medicare Assignment
85.52/100
CMS Quality Rating
7000 W PLANO PKWY STE 240, PLANO, TX 75093(972) 212-5476(972) 432-5438 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 16, 2024, Jul 3, 2024, Dec 11, 2019 and 2 more (5 updates tracked since 2016).

About Kalpesh Patel Md NPPES

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

KALPESH PATEL MD (NPI 1053572263) is an individual interventional cardiology provider in Plano, Texas, licensed in Virginia (0101249063) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Medical City Plano, and is a graduate of University Of Toledo College Of Medicine (2007).

NPPES Registry Identity

NPI1053572263
Entity TypeIndividualMale
Primary Taxonomy207RI0011X
Provider Legal NameKALPESH PATELCredential: MD
Location Address7000 W PLANO PKWY STE 240Plano, TX 75093-1637
Mailing Address7000 W Plano Pkwy Ste 240Plano, TX 75093-1637 · (972) 212-5476 · Fax (972) 432-5438
Phone(972) 212-5476
Fax(972) 432-5438
Sole ProprietorNo
Medical School CMSUniversity Of Toledo College Of MedicineGraduated 2007
Enumeration DateJune 19, 2008
Last NPPES UpdateJuly 16, 20245 updates tracked since enumeration
NPPES CertifiedJuly 16, 2024
✔ NPI 1053572263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
License✔ Licensed in VA · 0101249063
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
7000 W PLANO PKWY STE 240, Plano, TX 75093
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Kalpesh 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 ID1658508080
PECOS Enrollment IDI20190715002424
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

2

Medicare enrollment records show Kalpesh Patel reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Krpmed PLLC
Same address
Interventional Cardiology
7000 W PLANO PKWY STE 240
Plano, TX 75093
  • Reassigned Medicare billing, Texas enrollment
  • 2 clinicians in this Medicare group
NPI 1538910427 (972) 212-5476
Heart Smart Group
8.4 mi
Interventional Cardiology
6044 RACHEL DR
Frisco, TX 75034
  • Reassigned Medicare billing, Texas enrollment
  • 4 clinicians in this Medicare group
NPI 1407248404 (972) 896-5036

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 13

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 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.
438 services196 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.
388 services179 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.
101 services93 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.
74 services74 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.
71 services71 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.
42 services42 patients

Hospital Affiliations CMS Care Compare 4

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

Medical City Plano

Acute Care Hospitals · Plano, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450651
Location3901 W 15th StPlano, TX 75075 · Collin County
Emergency services Birthing friendly

Texas Health Presbyterian Hospital Plano

Acute Care Hospitals · Plano, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450771
Location6200 W Parker RdPlano, TX 75093 · Collin County
Emergency services Birthing friendly

Texas Health Presbyterian Hospital Allen

Acute Care Hospitals · Allen, TX
4/5 CMS rating
OwnershipGovernment - Federal
CMS Certification Number450840
Location1105 Central Expressway NorthAllen, TX 75013 · Collin County
Emergency services Birthing friendly

Baylor Scott & White The Heart Hospital - Plano

Acute Care Hospitals · Plano, TX
5/5 CMS rating
OwnershipProprietary
CMS Certification Number670025
Location1100 Allied DrivePlano, TX 75093 · Collin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75093 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

85.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.12
Improvement Activities40
Cost68.93

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
40%43 patients2/55-star benchmark: 100%
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
21%42 patients1/55-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.
90%1,685 patients4/55-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.
100%507 patients5/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
84%488 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
99%871 patients4/55-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
1%340 patients1/55-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…
13%863 patients1/55-star benchmark: 97%
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…
8%871 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+: 0% · 340 patients
0%340 patients5/55-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 4

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

MOHAMAD AMER ALAITI M.D.
Internal Medicine (Interventional Cardiology)
7000 W PLANO PKWY STE 240
PLANO, TX 75093
Collin County (214) 894-0456
KRPMED PLLC
Internal Medicine (Interventional Cardiology)
7000 W PLANO PKWY STE 240
PLANO, TX 75093
Collin County (972) 212-5476
FREDRICK SEBASTIAN LEACH MD
Urology
7000 W PLANO PKWY STE 240
PLANO, TX 75093
Collin County (972) 384-3470
HEART INSTITUTE OF TEXAS PLLC
Internal Medicine (Interventional Cardiology)
7000 W PLANO PKWY STE 240
PLANO, TX 75093
Collin County (214) 894-0456

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 Kalpesh Patel's NPI number?

The NPI number for Kalpesh Patel is 1053572263. It was assigned to this individual provider in the NPPES registry on June 19, 2008.

Where is Kalpesh Patel located?

Kalpesh Patel practices at 7000 W Plano Pkwy Ste 240, Plano, TX 75093. The listed phone number is (972) 212-5476.

What is Kalpesh Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Kalpesh Patel enrolled in Medicare?

Yes. Kalpesh 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 Kalpesh Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kalpesh Patel reassigns Medicare benefits to 2 organizations: Krpmed PLLC (Plano, TX) and Heart Smart Group (Frisco, TX). 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 Kalpesh Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kalpesh Patel accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 other insurers list Kalpesh 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 Kalpesh Patel affiliated with any hospitals?

According to CMS data, Kalpesh Patel is affiliated with Medical City Plano, Texas Health Presbyterian Hospital Plano, Texas Health Presbyterian Hospital Allen and Baylor Scott & White The Heart Hospital - Plano.

When was this NPI record last updated?

The NPPES record for Kalpesh Patel was last updated on July 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.