PRATIK PATEL M.D
NPI 1114337425
Hospitalist in Mansfield, OH

Q: What is Pratik Patel's NPI number?

The NPI number for Pratik Patel is 1114337425. It was assigned to this individual provider in the NPPES registry on May 8, 2014.

Q: What is Pratik Patel's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Pratik Patel was last updated on October 1, 2021. 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 May 08, 2014PECOS EnrolledAccepts Medicare Assignment

81.3/100

CMS Quality Rating

335 GLESSNER AVE, MANSFIELD, OH 44903(740) 383-8473(740) 383-8695 Get Directions Write a Review

NPPES record last updated: October 1, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Pratik Patel M.d NPPES

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

PRATIK PATEL M.D (NPI 1114337425) is an individual hospitalist provider in Mansfield, Ohio, licensed in Ohio (35.130722) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Marion General Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1114337425

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NamePRATIK PATELCredential: M.D

Location Address335 GLESSNER AVEMansfield, OH 44903-2269

Mailing AddressPo Box 7527Dublin, OH 43017-0727

Phone(740) 383-8473

Fax(740) 383-8695

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateMay 8, 2014

Last NPPES UpdateOctober 1, 2021

NPPES CertifiedOctober 1, 2021

✔ NPI 1114337425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in OH · 35.130722

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 35.130722 (OH)

335 GLESSNER AVE, Mansfield, OH 44903

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Oscar Health Maintenance Organization of Florida, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Pratik 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 ID648536912

PECOS Enrollment IDI20171102002855

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.

Medicare Billing Reassignments

Medicare enrollment records show Pratik Patel reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ohiohealth Corporation

56 mi

Thoracic Surgery (Cardiothoracic Vascular Surgery)

85 MCNAUGHTEN RD STE 110
Columbus, OH 43213

Reassigned Medicare billing, Ohio enrollment
3,314 clinicians in this Medicare group

NPI 1265627301 (614) 856-9100

Mercy Health Physicians Youngstown Specialty Care LLC

100 mi

Diagnostic Radiology

1932 NILES CORTLAND RD NE
Warren, OH 44484

Reassigned Medicare billing, Ohio enrollment
744 clinicians in this Medicare group

NPI 1255009601 (330) 306-5300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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.

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.

391 services181 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.

296 services176 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.

193 services180 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.

87 services85 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.

21 services21 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.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Marion General Hospital

Acute Care Hospitals · Marion, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360011

Location1000 Mckinley Park DriveMarion, OH 43302 · Marion County

Emergency services Birthing friendly

Ohiohealth Mansfield Hospital

Acute Care Hospitals · Mansfield, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360118

Location335 Glessner AvenueMansfield, OH 44903 · Richland County

Emergency services Birthing friendly

Ohiohealth Shelby Hospital

Critical Access Hospitals · Shelby, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number361324

Location199 West Main StreetShelby, OH 44875 · Richland County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44903 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

81.3/100

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

Scored as part of a group practice

Quality

73.58

Promoting Interoperability

Improvement Activities

Cost

65.77

Referred Medical Equipment & Supplies CMS DME claims 2

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

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

3 suppliers38 claims38 services$80.66 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

2 suppliers32 claims32 services$29.28 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.

MEREDITH L KROMER-EDWARDS AU.D

Audiologist