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DR. SANJAY BIPIN PATEL O.D.
NPI 1093763211
Optometrist in Apex, NC

Active since May 04, 2006PECOS EnrolledAccepts Medicare Assignment
800 W. WILLIAMS STREET, SUITE 164, APEX, NC 27513(919) 362-0332(919) 362-0933 Get Directions Write a Review

NPPES record last updated: November 9, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sanjay Bipin Patel O.d. NPPES

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

DR. SANJAY BIPIN PATEL O.D. (NPI 1093763211) is an individual optometrist in Apex, North Carolina, licensed in North Carolina (1963) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Pennsylvania College Of Optometry (2001).

NPPES Registry Identity

NPI1093763211
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. SANJAY BIPIN PATELCredential: O.D.
Location Address800 W. WILLIAMS STREET, SUITE 164Apex, NC 27513
Mailing Address1950 Old Gallows Rd, Suite 520Vienna, VA 22182-3990 · (703) 847-8899 · Fax (703) 991-0514
Phone(919) 362-0332
Fax(919) 362-0933
Sole ProprietorNo
Medical School CMSPennsylvania College Of OptometryGraduated 2001
Enumeration DateMay 4, 2006
Last NPPES UpdateNovember 9, 2017
✔ NPI 1093763211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in NC · 1963
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Also ListedOptometrist · Corneal and Contact ManagementTaxonomy 152WC0802X · License 1963 (NC)
800 W. WILLIAMS STREET, SUITE 164, Apex, NC 27513
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Other Identifiers 4

Medicaid5902150NC
Medicare PIN2458234NC
Other093T3NC · Bcbs Of Nc
Medicare UPINU91924NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee 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

Dr. Sanjay Bipin Patel O.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 ID5496749228
PECOS Enrollment IDI20051021000047
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 3

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.

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.
31 services26 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
14 services13 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 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.
14 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27513 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Sanjay Patel's NPI number?

The NPI number for Sanjay Patel is 1093763211. It was assigned to this individual provider in the NPPES registry on May 4, 2006.

Where is Sanjay Patel located?

Sanjay Patel practices at 800 W. Williams Street, Suite 164, Apex, NC 27513. The listed phone number is (919) 362-0332.

What is Sanjay Patel's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Sanjay Patel enrolled in Medicare?

Yes. Sanjay 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.

What insurance does Sanjay Patel accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana and 6 other insurers list Sanjay 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.

When was this NPI record last updated?

The NPPES record for Sanjay Patel was last updated on November 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.