KALPESH PRAHLADBHAI PATEL MD
NPI 1073732830
Internal Medicine - Pulmonary Disease in Kyle, TX

Q: What is the provider's specialty?

The provider's specialty is Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.

Active since April 24, 2007PECOS EnrolledAccepts Medicare Assignment

70.24/100

CMS Quality Rating

211 ELMHURST, SUITE D/E, KYLE, TX 78640(512) 410-4153 Get Directions Write a Review

NPPES record last updated: June 16, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kalpesh Prahladbhai Patel Md NPPES

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

KALPESH PRAHLADBHAI PATEL MD (NPI 1073732830) is an individual pulmonary disease provider in Kyle, Texas, licensed in Texas (N7649) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with Ascension Seton Medical Center Austin, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1073732830

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameKALPESH PRAHLADBHAI PATELCredential: MD

Location Address211 ELMHURST, SUITE D/EKyle, TX 78640-5982

Mailing Address211 Elmhurst, Suite D/eKyle, TX 78640-5982 · (512) 410-4153

Phone(512) 410-4153

Sole ProprietorYes

Medical School CMSOtherGraduated 1992

Enumeration DateApril 24, 2007

Last NPPES UpdateJune 16, 2014

✔ NPI 1073732830 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in TX · N7649

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.

211 ELMHURST, Kyle, TX 78640

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Other Identifiers 2

Medicare PINTXB126681TX

Medicare PINTXB126682TX

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kalpesh Prahladbhai 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 ID3274559901

PECOS Enrollment IDI20110602000017

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 33

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Follow-up hospital inpatient care per day, typically 35 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.

1,140 services251 patients

Follow-up hospital inpatient care per day, typically 25 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.

939 services131 patients

Established patient office or other outpatient visit, 30-39 minutes 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.

911 services510 patients

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.

316 services123 patients

Initial hospital inpatient care per day, typically 70 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.

200 services191 patients

Established patient office or other outpatient visit, 20-29 minutes 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.

175 services138 patients

Established patient office or other outpatient visit, 40-54 minutes 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.

171 services127 patients

New patient office or other outpatient visit, 60-74 minutes 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.

132 services132 patients

Sleep study including heart rate, breathing, and sleep time 95800

A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.

121 services59 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

112 services105 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.

106 services101 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.

105 services100 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.

104 services99 patients

Smoking and tobacco use intensive counseling, more than 10 minutes 99407

This service involves an in-depth discussion about the risks of smoking and tobacco use, spanning over 10 minutes. It provides personalized strategies to quit smoking, including coping techniques for withdrawal symptoms and triggers. The goal is to support your journey towards a healthier lifestyle.

74 services46 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

70 services67 patients

Test for exercise-induced lung stress 94618

66 services64 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

65 services64 patients

Test to determine lung volumes using gas dilution or washout 94727

64 services63 patients

Test to examine how well the lungs exchange gases 94729

64 services63 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

53 services50 patients

New patient office or other outpatient visit, 45-59 minutes 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.

48 services48 patients

Destruction of growth or narrowing of lung airway using an endoscope 31641

This procedure involves using a special tool called an endoscope to treat abnormal growths or narrowing in the lung airway. The endoscope, inserted through the mouth, allows the doctor to visualize and treat the affected area without making large incisions.

32 services27 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

31 services28 patients

Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 3 or more lymph nodes 31653

This procedure involves using a special scope and ultrasound to examine your lung airways and sample tissue from 3 or more lymph nodes. It aids in diagnosing lung conditions and checking lymph node health.

29 services28 patients

Biopsy of lobe of lung using an endoscope, 1 lobe 31628

A lung biopsy is a procedure where a small piece of lung tissue is taken for testing. An endoscope, a flexible tube with a light and camera, is used. It's inserted through the mouth or nose, down the windpipe, and into one lobe of the lung.

21 services20 patients

Hospital observation or inpatient care admitted and discharged on the same day for low severity problem, typically 40 minutes 99234

Hospital observation or inpatient care is a brief medical service where you're admitted and discharged on the same day. This typically lasts about 40 minutes and is for low severity issues. It involves monitoring your condition, administering necessary treatment, and ensuring your well-being before discharge.

20 services20 patients

Computer-assisted image-guided navigation of lung airways using an endoscope 31627

This procedure involves the use of a special camera, called an endoscope, and computer technology to create real-time images of your lung airways. This helps doctors navigate through your lungs accurately, aiding in diagnosis or treatment.

16 services15 patients

Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope 31629

A needle biopsy of windpipe cartilage, airway, or lung involves using a thin, flexible tube with a camera (endoscope) to access and collect tissue samples. This procedure helps doctors diagnose lung conditions or diseases effectively and safely.

15 services14 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

15 services15 patients

Emergent insertion of breathing tube into windpipe using an endoscope 31500

This is a procedure where a thin tube is inserted into your windpipe to aid in breathing. It's done in emergency situations, using an endoscope, a tool with a light and camera, to ensure correct placement.

14 services14 patients

Aspiration of fluid from chest cavity using imaging guidance 32555

This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.

14 services13 patients

Biopsy of lung airway using an endoscope 31625

A biopsy of the lung airway using an endoscope is a procedure where a small, flexible tube with a light and camera is inserted through your mouth or nose to reach your lungs. A tiny tool on the endoscope collects a small tissue sample for examination.

13 services13 patients

Placement of radiation therapy markers into lung airways using an endoscope 31626

This procedure involves inserting tiny markers into your lung airways with an endoscope, a thin tube with a light and camera. These markers help accurately target radiation therapy, improving its effectiveness in treating lung conditions.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Ascension Seton Medical Center Austin

Acute Care Hospitals · Austin, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450056

Location1201 W 38th StAustin, TX 78705 · Travis County

Emergency services Birthing friendly

Ascension Seton Hays

Acute Care Hospitals · Kyle, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number670056

Location6001 Kyle PkwyKyle, TX 78640 · Hays County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78640 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.

70.24/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

37.76

Promoting Interoperability

Improvement Activities

Cost

58.52

Referred Medical Equipment & Supplies CMS DME claims 29

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

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

19 suppliers445 claims445 services$31.70 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

20 suppliers397 claims397 services$69.34 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

19 suppliers391 claims1,090 services$26.19 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

18 suppliers222 claims1,149 services$14.72 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

13 suppliers107 claims599 services$12.32 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

20 suppliers331 claims332 services$46.40 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

24 suppliers402 claims402 services$14.15 avg. paid by Medicare

Chinstrap used with positive airway pressure device A7036

DME-Other DME · category DE001N

9 suppliers38 claims38 services$8.71 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

21 suppliers235 claims236 services$9.70 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

25 suppliers646 claims3,603 services$1.65 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

5 suppliers15 claims15 services$4.87 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

21 suppliers268 claims268 services$10.13 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

6 suppliers101 claims103 services$14.50 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers14 claims14 services$40.63 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

10 suppliers188 claims190 services$73.52 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0471

DME-Other DME · category DE001N

5 suppliers48 claims49 services$166.68 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

11 suppliers73 claims73 services$113.69 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

3 suppliers53 claims56 services$9.27 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

16 suppliers408 claims410 services$28.38 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

14 suppliers323 claims325 services$64.77 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

9 suppliers154 claims154 services$30.51 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

3 suppliers16 claims960 services$4.65 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

4 suppliers24 claims1,350 services$6.67 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

6 suppliers17 claims3,613 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

18 suppliers49 claims4,590 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

4 suppliers28 claims1,152 services$0.80 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

3 suppliers35 claims180,250 services$0.15 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$28.08 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

22 suppliers99 claims99 services$25.52 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure	Performance	Number of Patients
Controlling High Blood Pressure	58%	53
Documentation of Current Medications in the Medical Record	46%	3661
e-Prescribing	99%	2055
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	13%	1848
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented	23%	3274
Provide Patients Electronic Access to Their Health Information	48%	1973

Other Providers at the Same Location NPPES 3

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

LONE STAR ENT SPECIALISTS PA

Otolaryngology

211 ELMHURST, SUITE E
KYLE, TX 78640

Hays County (512) 268-5282

TEXAS LAPAROENDOSCOPIC SURGERY PLLC

Surgery

211 ELMHURST
KYLE, TX 78640

Hays County (512) 268-0800

TEXAS INSTITUTE OF INTERVENTIONAL PULMONARY & SLEEP, LTD

Clinic/Center (Multi-Specialty)

211 ELMHURST, SUITE D/E
KYLE, TX 78640

Hays County (512) 410-4153

KALPESH PRAHLADBHAI PATEL MD
NPI 1073732830
Internal Medicine - Pulmonary Disease in Kyle, TX

About Kalpesh Prahladbhai Patel Md NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 2

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare Enrollment Status

Areas of Expertise CMS Part B claims 33

Hospital Affiliations CMS Care Compare 2

Ascension Seton Medical Center Austin

Ascension Seton Hays

Physician Visit Costs CMS claims · ZIP area

Medicare Quality Performance CMS QPP · MIPS

Referred Medical Equipment & Supplies CMS DME claims 29

MIPS Quality Measures

Other Providers at the Same Location NPPES 3

Frequently Asked Questions

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