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DR. PRATIK PATEL OD
NPI 1134656366
Optometrist in Baltimore, MD

Active since May 18, 2017PECOS Enrolled
100/100
CMS Quality Rating
1800 ORLEANS ST, BALTIMORE, MD 21287(410) 933-1340 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 17, 2025, Nov 11, 2025, Jun 18, 2018 and 2 more (5 updates tracked since 2017).

About Dr. Pratik Patel Od NPPES

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

DR. PRATIK PATEL OD (NPI 1134656366) is an individual optometrist in Baltimore, Maryland, licensed in Maryland (TA3115) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1134656366
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. PRATIK PATELCredential: OD
Location Address1800 ORLEANS STBaltimore, MD 21287-0010
Mailing Address6201 Greenleigh AveMiddle River, MD 21220-2004 · (410) 955-5000
Phone(410) 933-1340
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMay 18, 2017
Last NPPES UpdateNovember 17, 20255 updates tracked since enumeration
NPPES CertifiedNovember 17, 2025
✔ NPI 1134656366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in MD · TA3115✔ Licensed in NY · TUV008739-1✔ Licensed in OH · OPT.6572
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.
1800 ORLEANS ST, Baltimore, MD 21287
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11305 York Ave Fl 11New York, NY 10021 · Phone (646) 962-2020 · Fax (646) 962-0602
Location 2915 Olentangy River RdColumbus, OH 43212-3153 · Phone (614) 293-8116

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Pratik Patel Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6800146713
PECOS Enrollment IDI20180913001100, I20251122000370
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 7

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 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.
143 services129 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
98 services90 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
69 services55 patients
New patient problem focused exam of visual system 92002
A new patient problem-focused exam of the visual system is a basic evaluation of your eyes and vision. It includes checking your eye movements, visual acuity, and general eye health. It helps detect any potential issues early for timely treatment.
37 services37 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.
19 services19 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21287 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
$139.05 typical visit price
range $60.73 – $183.44
Typical copayment $34.76 (range $15.18 – $45.86)
Most-billed visit code 99204
Established Patient
$75.47 typical visit price
range $19.60 – $149.17
Typical copayment $18.86 (range $4.90 – $37.29)
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.

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.8
Promoting Interoperability100
Improvement Activities40

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.

KATHRYN ROSENBLATT M.D.
Anesthesiology
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-7461
DR. CARMEL BOGLE M.D.
Pediatrics
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (443) 287-0526
MIAN MOHAMMAD BILAL KHALID MD
Internal Medicine (Gastroenterology)
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5000
SPENCER WILSON
Surgery (Trauma Surgery)
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 933-6423
EVAN FOX
Radiology (Neuroradiology)
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5000
ADAM ROBERT BUSSELLS
Physician Assistant
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5000
DR. SARAH WALSER MD
Student in an Organized Health Care Education/Training Program
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (484) 883-6433
LYNN DESROSIERS FNP-C
Nurse Practitioner (Family)
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-2800

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 Pratik Patel's NPI number?

The NPI number for Pratik Patel is 1134656366. It was assigned to this individual provider in the NPPES registry on May 18, 2017.

Where is Pratik Patel located?

Pratik Patel practices at 1800 Orleans St, Baltimore, MD 21287. The listed phone number is (410) 933-1340.

What is Pratik Patel's specialty?

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

Is Pratik Patel enrolled in Medicare?

Yes. Pratik Patel is registered in the Medicare PECOS enrollment system.

What insurance does Pratik Patel accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Pratik 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 Pratik Patel was last updated on November 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.