DR. DEREK R PATEL M.D.
NPI 1073538385
Internal Medicine - Gastroenterology in San Diego, CA

Active since July 13, 2006PECOS EnrolledAccepts Medicare Assignment
79.44/100
CMS Quality Rating
200 W ARBOR DR, MAIL CODE 8413, SAN DIEGO, CA 92103(619) 543-5321 Get Directions Write a Review

NPPES record last updated: October 18, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Derek R Patel M.d. NPPES

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

DR. DEREK R PATEL M.D. (NPI 1073538385) is an individual gastroenterology provider in San Diego, California, licensed in California (A69111) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (1997).

NPPES Registry Identity

NPI1073538385
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. DEREK R PATELCredential: M.D.
Location Address200 W ARBOR DR, MAIL CODE 8413San Diego, CA 92103-9001
Mailing AddressPo Box 232410San Diego, CA 92193-2410
Sole ProprietorNo
Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 1997
Enumeration DateJuly 13, 2006
Last NPPES UpdateOctober 18, 2018
NPI 1073538385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in CA · A69111
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Also ListedInternal MedicineTaxonomy 207R00000X · License A69111 (CA)
200 W ARBOR DR, San Diego, CA 92103

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. Derek R 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 ID3779778477
PECOS Enrollment IDI20101108000834
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 14

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.

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
108 services107 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.
95 services59 patients
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito G0500
Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.
89 services88 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
48 services47 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
44 services44 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.
40 services40 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 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
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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.

79.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality88.33
Improvement Activities0
Cost69.53

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each A4413
DME-Orthotic Devices · category DF010N
1 supplier11 claims255 services$5.32 avg. paid by Medicare
Parenteral nutrition solution, not otherwise specified, 10 grams lipids B4185
Other-Enteral and Parenteral · category OB005N
1 supplier20 claims159 services$11.35 avg. paid by Medicare
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix B4193
Other-Enteral and Parenteral · category OB005N
1 supplier15 claims102 services$232.49 avg. paid by Medicare
Parenteral nutrition supply kit; premix, per day B4220
Other-Enteral and Parenteral · category OB005N
1 supplier21 claims144 services$8.09 avg. paid by Medicare
Parenteral nutrition administration kit, per day B4224
Other-Enteral and Parenteral · category OB005N
1 supplier21 claims144 services$25.26 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Internal Medicine (Geriatric Medicine)
200 W ARBOR DR
SAN DIEGO, CA 92103
Hospice, Inpatient
200 W ARBOR DR
SAN DIEGO, CA 92103
Anesthesiology
200 W ARBOR DR
SAN DIEGO, CA 92103
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
Nurse Practitioner (Psychiatric/Mental Health)
200 W ARBOR DR
SAN DIEGO, CA 92103
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
Student in an Organized Health Care Education/Training Program
200 W ARBOR DR
SAN DIEGO, CA 92103
Physician Assistant (Surgical)
200 W ARBOR DR
SAN DIEGO, CA 92103

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 Derek Patel's NPI number?

The NPI number for Derek Patel is 1073538385. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Derek Patel located?

Derek Patel practices at 200 W Arbor Dr Mail Code 8413, San Diego, CA 92103. The listed phone number is (619) 543-5321.

What is Derek Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Derek Patel enrolled in Medicare?

Yes. Derek 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.

When was this NPI record last updated?

The NPPES record for Derek Patel was last updated on October 18, 2018. 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.