FALGUN D PATEL MD
NPI 1093036089
Internal Medicine - Interventional Cardiology in Gainesville, GA

Q: What is Falgun Patel's NPI number?

The NPI number for Falgun Patel is 1093036089. It was assigned to this individual provider in the NPPES registry on June 14, 2010.

Q: What is Falgun Patel's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Falgun Patel was last updated on December 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 June 14, 2010PECOS EnrolledAccepts Medicare Assignment

78.35/100

CMS Quality Rating

743 SPRING ST NE, GAINESVILLE, GA 30501(770) 534-2020(770) 534-8025 Get Directions Write a Review

NPPES record last updated: December 7, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 7, 2020, Feb 5, 2020, Dec 9, 2019 and 5 more (8 updates tracked since 2017).

On this page

About Falgun D Patel Md NPPES

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

FALGUN D PATEL MD (NPI 1093036089) is an individual interventional cardiology provider in Gainesville, Georgia, licensed in Georgia (75226) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1093036089

Entity TypeIndividualMale

Primary Taxonomy207RI0011X

Provider Legal NameFALGUN D PATELCredential: MD

Location Address743 SPRING ST NEGainesville, GA 30501-3715

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420

Phone(770) 534-2020

Fax(770) 534-8025

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateJune 14, 2010

Last NPPES UpdateDecember 7, 20208 updates tracked since enumeration

NPPES CertifiedDecember 7, 2020

✔ NPI 1093036089 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 GA · 75226

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.

743 SPRING ST NE, Gainesville, GA 30501

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Wellpoint.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

Falgun D 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 ID5698033587

PECOS Enrollment IDI20171226000879

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 30

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 only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

1,536 services1,238 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.

256 services178 patients

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.

240 services224 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

159 services145 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

114 services109 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.

106 services101 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

96 services84 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel 92978

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

79 services73 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.

65 services65 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

62 services57 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.

61 services46 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

59 services59 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.

56 services44 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

39 services39 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.

36 services36 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.

34 services30 patients

Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan 78431

This is a diagnostic test where a tiny amount of radioactive material is used to examine your heart's blood flow at rest & during stress, alongside a CT scan for detailed images. It helps identify any heart-related issues like blockages or damage.

33 services33 patients

Nuclear medicine study of heart muscle blood flow by pet 78434

A nuclear medicine study of heart muscle blood flow by PET is a non-invasive test that uses a small amount of radioactive substance to create detailed images of your heart's blood flow and function. It helps assess heart health and diagnose heart conditions.

33 services33 patients

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.

31 services23 patients

Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel 93571

This procedure involves using ultrasound technology to examine the first blood vessel of your heart. It helps identify any abnormalities or issues, providing crucial information for diagnosis or treatment. It's a safe, non-invasive process.

30 services29 patients

Heart muscle strain imaging 93356

Heart muscle strain imaging is a non-invasive test that uses sound waves to create pictures of your heart. It helps doctors evaluate how well your heart muscle is working and detect any damage or disease. This can aid in diagnosing heart conditions and guiding treatment plans.

27 services27 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

24 services19 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.

24 services24 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.

23 services23 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.

23 services23 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

22 services17 patients

Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist 93459

This procedure involves placing a tube into your left lower heart chamber, coronary artery, and bypass graft. It's done for diagnostic purposes and is carefully reviewed by a radiologist. This helps determine the health of your heart and arteries, aiding in future treatment plans.

20 services20 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

19 services15 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 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.

19 services19 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

14 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number110029

Location743 Spring StreetGainesville, GA 30501 · Hall County

Emergency services Birthing friendly

Northeast Georgia Medical Center Habersham

Acute Care Hospitals · Demorest, GA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110041

Location541 Historic Highway 441-NorthDemorest, GA 30535 · Habersham County

Emergency services Birthing friendly

Ngmc Barrow, LLC

Acute Care Hospitals · Winder, GA

OwnershipProprietary

CMS Certification Number110045

Location316 North Broad StreetWinder, GA 30680 · Barrow County

Emergency services

Union General Hospital

Acute Care Hospitals · Blairsville, GA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110051

Location35 Hospital RoadBlairsville, GA 30512 · Union County

Emergency services Birthing friendly

Northeast Georgia Medical Center Lumpkin

Acute Care Hospitals · Dahlonega, GA

OwnershipVoluntary non-profit - Other

CMS Certification Number110237

Location495 Highway 400 NorthDahlonega, GA 30533 · Lumpkin County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

78.35/100

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

Scored as part of a group practice

Quality

76.17

Promoting Interoperability

Improvement Activities

Cost

60.82

Reported Quality Measures

Cardiac Rehabilitation Patient Referral from an Outpatient Setting

Percentage of patients evaluated in an outpatient setting who within the previous 12 months have experienced an acute myocardial infarction (MI), coronary artery bypass graft (CABG) surgery, a percutaneous coronary intervention (PCI), cardiac valve surgery…

4%149 patients1/55-star benchmark: 91%

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…

73%1,136 patients3/55-star benchmark: 100%

Coronary Artery Disease (CAD): Antiplatelet Therapy

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel

85%707 patients3/55-star benchmark: 100%

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.

98%3,296 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.

97%2,341 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

59%223 patients3/55-star benchmark: 88%

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.

98%265 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.

95%1,648 patients4/55-star benchmark: 97%

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…

42%1,620 patients2/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 99% · 864 patients

Patients tobacco: 56% · 52 patients

94%792 patients4/55-star benchmark: 98%

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…

99%1,648 patients4/55-star benchmark: 100%

Secure Messaging

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…

11%1,648 patients1/55-star benchmark: 89%

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% · 1,047 patients

0%1,047 patients5/55-star benchmark: 100%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

21%1,648 patients

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 20

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

DARRYL E BLALOCK CRNA

Nurse Anesthetist, Certified Registered