DR. PANKAJ A PATEL M.D.
NPI 1124022082
Internal Medicine - Gastroenterology in South Bend, IN

Q: What is Pankaj Patel's NPI number?

The NPI number for Pankaj Patel is 1124022082. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Q: What is Pankaj Patel's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Pankaj Patel was last updated on January 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 09, 2005PECOS EnrolledAccepts Medicare Assignment

68.49/100

CMS Quality Rating

17501 GENERATIONS DR, SOUTH BEND, IN 46635(574) 234-0049(574) 251-2861 Get Directions Write a Review

NPPES record last updated: January 21, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Pankaj A Patel M.d. NPPES

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

DR. PANKAJ A PATEL M.D. (NPI 1124022082) is an individual gastroenterology provider in South Bend, Indiana, licensed in Indiana (01049700A) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Regional Medical Center, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1124022082

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. PANKAJ A PATELCredential: M.D.

Location Address17501 GENERATIONS DRSouth Bend, IN 46635-1589

Mailing Address17501 Generations DrSouth Bend, IN 46635-1589 · (574) 234-0049 · Fax (574) 251-2861

Phone(574) 234-0049

Fax(574) 251-2861

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateJune 9, 2005

Last NPPES UpdateJanuary 21, 2011

✔ NPI 1124022082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in IN · 01049700A

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.

17501 GENERATIONS DR, South Bend, IN 46635

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Other Identifiers 7

Other7580376IN · Aetna

Medicare PIN736980FIN

Other100016227IN · Railroad Medicare

Medicare UPINH43060IN

Other000000225361IN · Bcbs

Other0649925002IN · Cigna

Medicaid200377140AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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. Pankaj A 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 ID5496852139

PECOS Enrollment IDI20101101000938

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 15

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.

209 services209 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.

189 services183 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.

54 services54 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

47 services46 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.

46 services46 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.

46 services40 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

42 services41 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

42 services41 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.

42 services39 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

34 services34 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.

30 services30 patients

Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare 43251

This procedure involves the use of a thin, flexible instrument called an endoscope to visualize and remove abnormal growths, known as polyps, from the esophagus, stomach, or upper small bowel. A tool called a mechanical snare is used to safely cut and remove these growths.

24 services24 patients

Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43255

This procedure involves using a flexible tube with a light, called an endoscope, to examine and treat bleeding in the esophagus, stomach, or upper small bowel. It's a safe, effective way to control bleeding and ensure your digestive health.

14 services14 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.

14 services14 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Saint Joseph Regional Medical Center

Acute Care Hospitals · Mishawaka, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150012

Location5215 Holy Cross PkwyMishawaka, IN 46545 · St. Joseph County

Emergency services Birthing friendly

Memorial Hospital Of South Bend

Acute Care Hospitals · South Bend, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150058

Location615 N Michigan StSouth Bend, IN 46601 · St. Joseph County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46635 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

68.49/100

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

Individually scored

Quality

51.83

Improvement Activities

Cost

59.21

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

15%41 patients1/55-star benchmark: 87%

Colorectal Cancer Screening

33%389 patients2/55-star benchmark: 88%

Controlling High Blood Pressure

46%234 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

33%823 patients1/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%269 patients1/55-star benchmark: 100%

HIV Screening

0%391 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

51%641 patients3/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

6%823 patients1/55-star benchmark: 61%

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

Patients combinedPopulations: 52% · 653 patients

Patients screened: 88% · 653 patients

1%157 patients1/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 269 patients

Patients totalRate: 1% · 269 patients

1%269 patients4/55-star benchmark: 100%

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 11

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

BRIANA R WEIDLER-EDHOLM NP

Nurse Practitioner