KETAN PATEL M.D.
NPI 1174721310
Internal Medicine - Pulmonary Disease in Tyler, TX

Active since July 10, 2007PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
912 S FLEISHEL AVE, TYLER, TX 75701(903) 592-6901(903) 595-2571 Get Directions Write a Review

NPPES record last updated: November 5, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ketan Patel M.d. NPPES

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

KETAN PATEL M.D. (NPI 1174721310) is an individual pulmonary disease provider in Tyler, Texas, licensed in Texas (N7858) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1174721310
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameKETAN PATELCredential: M.D.
Location Address912 S FLEISHEL AVETyler, TX 75701-2018
Mailing Address912 S Fleishel AveTyler, TX 75701-2018 · (903) 592-6901 · Fax (903) 595-2571
Fax(903) 595-2571
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJuly 10, 2007
Last NPPES UpdateNovember 5, 2013
NPI 1174721310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in TX · N7858
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedSpecialistTaxonomy 174400000X · License N7858 (TX)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License N7858 (TX)
912 S FLEISHEL AVE, Tyler, TX 75701

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

Ketan 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 ID1557539798
PECOS Enrollment IDI20110714000331
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 34

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.
507 services380 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.
480 services152 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.
341 services141 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.
192 services160 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
153 services151 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
151 services150 patients

Hospital Affiliations CMS Care Compare 5

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

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450083
Location1000 South Beckham AveTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Ut Health East Texas Jacksonville Hospital

Acute Care Hospitals · Jacksonville, TX
OwnershipProprietary
CMS Certification Number450194
Location501 S RagsdaleJacksonville, TX 75766 · Cherokee County
Emergency services Birthing friendly

Ut Health East Texas Carthage Hospital

Acute Care Hospitals · Carthage, TX
OwnershipProprietary
CMS Certification Number450210
Location409 Cottage RdCarthage, TX 75633 · Panola County
Emergency services

Ut Health East Texas Athens Hospital

Acute Care Hospitals · Athens, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450389
Location2000 South Palestine StAthens, TX 75751 · Henderson County
Emergency services Birthing friendly

Ut Health East Texas Henderson Hospital

Acute Care Hospitals · Henderson, TX
OwnershipProprietary
CMS Certification Number450475
Location300 Wilson StreetHenderson, TX 75652 · Rusk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
89%2,923 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
93%1,393 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
87%23 patients4/55-star benchmark: 96%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%2,669 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
0%2,560 patients1/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
25%1,393 patients2/55-star benchmark: 90%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
88%2,560 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
2%2,560 patients1/55-star benchmark: 59%
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.

Referred Medical Equipment & Supplies CMS DME claims 35

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
26 suppliers311 claims311 services$38.74 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
4 suppliers47 claims97 services$1.59 avg. paid by Medicare
Small volume nonfiltered pneumatic nebulizer, disposable A7004
DME-Other DME · category DE000N
1 supplier12 claims24 services$1.32 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005
DME-Other DME · category DE000N
6 suppliers23 claims23 services$13.71 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
29 suppliers502 claims504 services$96.91 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
30 suppliers557 claims1,451 services$37.16 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.

Internal Medicine (Pulmonary Disease)
912 S FLEISHEL AVE
TYLER, TX 75701
Nurse Practitioner
912 S FLEISHEL AVE
TYLER, TX 75701
Nurse Practitioner
912 S FLEISHEL AVE
TYLER, TX 75701
Nurse Practitioner
912 S FLEISHEL AVE
TYLER, TX 75701
Internal Medicine (Pulmonary Disease)
912 S FLEISHEL AVE
TYLER, TX 75701
Nurse Practitioner (Family)
912 S FLEISHEL AVE
TYLER, TX 75701
Nurse Practitioner (Acute Care)
912 S FLEISHEL AVE
TYLER, TX 75701
Durable Medical Equipment & Medical Supplies
912 S FLEISHEL AVE
TYLER, TX 75701

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 Ketan Patel's NPI number?

The NPI number for Ketan Patel is 1174721310. It was assigned to this individual provider in the NPPES registry on July 10, 2007.

Where is Ketan Patel located?

Ketan Patel practices at 912 S Fleishel Ave, Tyler, TX 75701. The listed phone number is (903) 592-6901.

What is Ketan Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Ketan Patel enrolled in Medicare?

Yes. Ketan 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 Ketan Patel accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Ketan 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 Ketan Patel affiliated with any hospitals?

According to CMS data, Ketan Patel is affiliated with Ut Health East Texas Tyler Regional Hospital, Ut Health East Texas Jacksonville Hospital, Ut Health East Texas Carthage Hospital, Ut Health East Texas Athens Hospital and Ut Health East Texas Henderson Hospital.

When was this NPI record last updated?

The NPPES record for Ketan Patel was last updated on November 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.