DR. SARIT M PATEL M.D.
NPI 1073500047
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in New Britain, CT

NPI Status: Active since October 04, 2005

Contact Information

1 LAKE ST
GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT
ZIP 06052
Phone: (860) 826-4460
Fax: (860) 826-4436

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  • Individual
  • Male
  • Years of Experience 28
  • Ophthalmology
  • Ophthalmic Plastic and Reconstructive Su...
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About SARIT PATEL

This page provides the complete NPI Profile along with additional information for Sarit Patel, a provider established in New Britain, Connecticut with a medical specialization in Ophthalmology, focusing in ophthalmic plastic and reconstructive surgery and more than 28 years of experience. He graduated from Perelman School Of Med At The University Of Pennsylvania in 1998. The healthcare provider is registered in the NPI registry with number 1073500047 assigned on October 2005. The practitioner's primary taxonomy code is 207WX0200X with license number 043082 (CT). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1073500047
Provider Name
DR. SARIT M PATEL M.D.
Gender
Male
Entity Type
Individual
Location Address
1 LAKE ST GROVE HILL MEDICAL CENTER NEW BRITAIN, CT 06052
Location Phone
(860) 826-4460
Location Fax
(860) 826-4436
Mailing Address
2110 SILAS DEANE HWY ROCKY HILL, CT 06067
Mailing Phone
(860) 826-4460
Mailing Fax
(860) 826-4436
Medical School Name
PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Graduation Year
1998
Is Sole Proprietor?
No
Enumeration Date
10-04-2005
Last Update Date
08-30-2018
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Ophthalmology Ophthalmic Plastic and Reconstructive Surgery

Taxonomy Code
207WX0200X
Type
Allopathic & Osteopathic Physicians
License No.
043082
License State
CT
Taxonomy Description
A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207W00000XAllopathic & Osteopathic Physicians

Ophthalmology

043082 (CT)
2207WX0200XAllopathic & Osteopathic Physicians

Ophthalmology
Ophthalmic Plastic and Reconstructive Surgery

238678 (MA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Focus Bronze POS? 205 - POS
  • Blue Focus Bronze POS? 705 - POS
  • Blue Focus Bronze POS? Standard - POS
  • Blue Focus Gold POS? 207 - POS
  • Blue Focus Gold POS? 902 - POS
  • Blue Focus Gold POS? Standard - POS
  • Blue Focus Silver POS? 206 - POS
  • Blue Focus Silver POS? 903 - POS
  • Blue Focus Silver POS? Standard - POS
  • Blue Preferred Bronze PPO? 201 - PPO
  • Blue Preferred Bronze PPO? 202 - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? 204 - PPO
  • Blue Preferred Gold PPO? 901 - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? 203 - PPO
  • Blue Preferred Silver PPO? 308 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • Blue Advantage Bronze PPO? 202 - PPO
  • Blue Advantage Bronze PPO? 203 - PPO
  • Blue Advantage Bronze PPO? Standard - PPO
  • Blue Advantage Gold PPO? 309 - PPO
  • Blue Advantage Gold PPO? 604 - PPO
  • Blue Advantage Gold PPO? Standard - PPO
  • Blue Advantage Silver PPO? 204 - PPO
  • Blue Advantage Silver PPO? 501 - PPO
  • Blue Advantage Silver PPO? Standard - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • MyBlue Bronze HMO? 902 - HMO
  • MyBlue Bronze HMO? 904 - HMO
  • MyBlue Bronze HMO? Standard - HMO
  • MyBlue Gold HMO? 704 - HMO
  • MyBlue Gold HMO? 804 - HMO
  • MyBlue Gold HMO? Standard - HMO
  • MyBlue Silver HMO? 705 - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
004214433MEDICAID (05)CT 
2V6932OTHER (01)CTHEALTH NET
010043082CT01OTHER (01)CTBCBS & BCFP NEW BRITAIN
367865OTHER (01)CTWELLCARE MEDICARE
001430826MEDICAID (05)CT 
2348526OTHER (01)CTCIGNA
043082OTHER (01)CTCONNECTICARE
1255448155OTHER (01)CTGHMC NPI ID
010043082CT02OTHER (01)CTBCBS & BCFP MERIDEN
3986052OTHER (01)CTAETNA
P3602477OTHER (01)CTOXFORD

Medicare Participation & PECOS Enrollment Status

Sarit Patel is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Sarit Patel is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4284628553

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20050620000533

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Closure of tear duct opening using plug

Closure of the tear duct opening using a plug is a procedure to address excessive tear production. A small device is inserted into the tear duct to block it, reducing tear flow and relieving symptoms. This is a safe, reversible process, often performed in-office.

This service was performed 85 times for 47 patients

Established patient complete exam of visual system

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.

This service was performed 109 times for 106 patients

Established patient problem focused exam of visual system

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.

This service was performed 352 times for 207 patients

Exam of visual field with intermediate testing

An exam of the visual field with intermediate testing is a procedure that checks your peripheral (side) vision. It helps to identify blind spots which could be a sign of eye diseases. This non-invasive test is painless and quick.

This service was performed 34 times for 32 patients

Extensive repair of turning-outward eyelid defect

This procedure corrects an eyelid defect where the eyelid turns outward, exposing the eye. The extensive repair involves surgical techniques to reshape the eyelid and ensure it functions properly. This helps protect the eye and improve comfort.

This service was performed 13 times for 11 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 50 patients

New patient complete exam of visual system

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.

This service was performed 30 times for 30 patients

New patient problem focused exam of visual system

A new patient problem-focused exam of the visual system is a basic evaluation of your eyes and vision. It includes checking your eye movements, visual acuity, and general eye health. It helps detect any potential issues early for timely treatment.

This service was performed 68 times for 68 patients

Photography of content of eyes

Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.

This service was performed 149 times for 142 patients

Probing of nasal tear duct

Probing of the nasal tear duct is a procedure to treat blocked tear ducts. A thin, flexible instrument is gently inserted into the tear duct to clear any obstruction, allowing tears to drain normally again. This procedure is typically quick and can help to alleviate symptoms like excessive tearing or infection.

This service was performed 56 times for 53 patients

Removal of growth of eyelid

The removal of an eyelid growth is a procedure performed to eliminate abnormal tissue from your eyelid. It's generally a quick, outpatient treatment. The doctor numbs your eyelid, carefully removes the growth, and may stitch the area if necessary. This can help maintain eye health and vision.

This service was performed 35 times for 30 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

This service was performed 12 times for 12 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $34.71 for a new patient copayment and $18.88 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 06052 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $138.84
  • Minimum New Patient Price $60.82
  • Maximum New Patient Price $183.1
  • Average New Patient Copayment $34.71
  • Minimum New Patient Copayment $15.2
  • Maximum New Patient Copayment $45.77

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $75.55
  • Minimum Established Patient Price $19.76
  • Maximum Established Patient Price $149.26
  • Average Established Patient Copayment $18.88
  • Minimum Established Patient Copayment $4.94
  • Maximum Established Patient Copayment $37.31

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
e-Prescribing 98% 1177
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Medication Reconciliation 76% 546
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.
Participation in CAHPS or other supplemental questionnaireYesN/A
Participation in the Consumer Assessment of Healthcare Providers and Systems Survey or other supplemental questionnaire items (e.g., Cultural Competence or Health Information Technology supplemental item sets).
Patient-Specific Education 7% 1647
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.
Provide Patient Access 10% 1647
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 certain information.
Secure Messaging 1% 1647
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1073500047, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 43. The final step is to find the difference between that total and the next multiple of ten (50 - 43 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
3
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
0
Unchanged
Pos 7
0
Doubled → 0
Pos 8
0
Unchanged
Pos 9
4
Doubled → 8
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 0 → 0 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 1 + 0 + 0 + 0 + 0 + 8 + 24 = 43

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 43 is 50. The difference is the calculated check digit.

50 - 43 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1073500047.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Urology
1 LAKE ST, BLDG B2ND
NEW BRITAIN, CT 06052
Ophthalmology
1 LAKE ST
NEW BRITAIN, CT 06052
Internal Medicine (Cardiovascular Disease)
1 LAKE ST
NEW BRITAIN, CT 06052
Urology
1 LAKE ST
NEW BRITAIN, CT 06052
Internal Medicine (Cardiovascular Disease)
1 LAKE ST, GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT 06052
Surgery
1 LAKE ST, GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT 06052
Internal Medicine (Cardiovascular Disease)
1 LAKE ST, GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT 06052
Ophthalmology
1 LAKE ST, GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT 06052
Internal Medicine (Cardiovascular Disease)
1 LAKE ST, GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT 06052
Urology
1 LAKE ST, GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT 06052
Ophthalmology
1 LAKE ST, GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT 06052
Surgery
1 LAKE ST, GROVE HILL MEDICAL CENTER
NEW BRITAIN, CT 06052
Urology
1 LAKE ST
NEW BRITAIN, CT 06052
Dentist (Oral and Maxillofacial Surgery)
1 LAKE ST, SUITE 101
NEW BRITAIN, CT 06052
Physical Therapist
1 LAKE ST
NEW BRITAIN, CT 06052
Physical Therapist
1 LAKE ST
NEW BRITAIN, CT 06052
Dentist (Pediatric Dentistry)
1 LAKE ST, BUILDING B
NEW BRITAIN, CT 06052
Dentist (Pediatric Dentistry)
1 LAKE ST, BUILDING B
NEW BRITAIN, CT 06052
Dentist (Pediatric Dentistry)
1 LAKE ST, BUILDING B
NEW BRITAIN, CT 06052
Physical Therapist
1 LAKE ST
NEW BRITAIN, CT 06052

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073500047, enumerated as an "individual" on October 04, 2005.

The provider is located at 1 LAKE ST GROVE HILL MEDICAL CENTER NEW BRITAIN, CT 06052 and the phone number is (860) 826-4460.

Ophthalmology with taxonomy code 207WX0200X and a focus in Ophthalmic Plastic and Reconstructive Surgery.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to verify.