RAJ NATVARLAL PATEL MD
NPI 1164715553
Ophthalmology in Hendersonville, NC

Active since May 18, 2011PECOS EnrolledAccepts Medicare Assignment
98.42/100
CMS Quality Rating
1701 OLD VILLAGE RD, HENDERSONVILLE, NC 28791(800) 624-6575 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 21, 2022, Apr 10, 2019, Jul 5, 2017 and 2 more (5 updates tracked since 2016).

About Raj Natvarlal Patel Md NPPES

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

RAJ NATVARLAL PATEL MD (NPI 1164715553) is an individual ophthalmology provider in Hendersonville, North Carolina, licensed in North Carolina (2017-01258) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS, is affiliated with Margaret R Pardee Memorial Hospital, and is a graduate of Tulane University School Of Medicine (2011).

NPPES Registry Identity

NPI1164715553
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameRAJ NATVARLAL PATELCredential: MD
Location Address1701 OLD VILLAGE RDHendersonville, NC 28791-3772
Mailing Address1701 Old Village RdHendersonville, NC 28791-3772 · (800) 624-6575
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 2011
Enumeration DateMay 18, 2011
Last NPPES UpdateJuly 21, 20225 updates tracked since enumeration
NPI 1164715553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in NC · 2017-01258
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
1701 OLD VILLAGE RD, Hendersonville, NC 28791

Accepted 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

Raj Natvarlal 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 ID8820391105
PECOS Enrollment IDI20170801002823
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 14

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
119,641 services416 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
3,580 services1,277 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
2,283 services458 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.
1,073 services771 patients
Extended exam of the back part of the eye with retinal drawing 92201
This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.
340 services339 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.
212 services211 patients

Hospital Affiliations CMS Care Compare

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

Margaret R Pardee Memorial Hospital

Acute Care Hospitals · Hendersonville, NC
5/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number340017
Location800 N Justice StHendersonville, NC 28791 · Henderson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28791 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.

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.

98.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality96.84
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
98%367 patients4/55-star benchmark: 100%
Diabetic Macular Edema - Loss of Visual Acuity
100%173 patients
Glaucoma Intraocular Pressure Reduction
94%130 patients
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 2,014 patients
Patients totalRate: 0% · 2,014 patients
0%2,014 patients5/55-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 8

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

Ophthalmology (Retina Specialist)
1701 OLD VILLAGE RD
HENDERSONVILLE, NC 28791
Ophthalmology
1701 OLD VILLAGE RD
HENDERSONVILLE, NC 28791
Ophthalmology
1701 OLD VILLAGE RD
HENDERSONVILLE, NC 28791
Ophthalmology
1701 OLD VILLAGE RD
HENDERSONVILLE, NC 28791
Ophthalmology
1701 OLD VILLAGE RD
HENDERSONVILLE, NC 28791
Ophthalmology
1701 OLD VILLAGE RD
HENDERSONVILLE, NC 28791
Ophthalmology
1701 OLD VILLAGE RD
HENDERSONVILLE, NC 28791
Ophthalmology
1701 OLD VILLAGE RD
HENDERSONVILLE, NC 28791

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 Raj Patel's NPI number?

The NPI number for Raj Patel is 1164715553. It was assigned to this individual provider in the NPPES registry on May 18, 2011.

Where is Raj Patel located?

Raj Patel practices at 1701 Old Village Rd, Hendersonville, NC 28791. The listed phone number is (800) 624-6575.

What is Raj Patel's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Raj Patel enrolled in Medicare?

Yes. Raj 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 Raj Patel accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC and First Choice Next and 3 other insurers list Raj 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.

Is Raj Patel affiliated with any hospitals?

According to CMS data, Raj Patel is affiliated with Margaret R Pardee Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Raj Patel was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.