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DR. SHIVALI M PATEL M.D.
NPI 1184043853
Family Medicine in Johnson City, TN

Active since April 10, 2014PECOS EnrolledAccepts Medicare Assignment
400 N STATE OF FRANKLIN RD FL 4, JOHNSON CITY, TN 37604(423) 431-1961(423) 431-2961 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Jul 21, 2017 (2 updates tracked since 2017).

About Dr. Shivali M Patel M.d. NPPES

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

DR. SHIVALI M PATEL M.D. (NPI 1184043853) is an individual family medicine provider in Johnson City, Tennessee, licensed in Tennessee (56189) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS, is affiliated with Johnson City Medical Center, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1184043853
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHIVALI M PATELCredential: M.D.
Location Address400 N STATE OF FRANKLIN RD FL 4Johnson City, TN 37604-6035
Mailing AddressPo Box 4018Johnson City, TN 37602-4018 · (423) 282-1480 · Fax (423) 928-1353
Phone(423) 431-1961
Fax(423) 431-2961
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateApril 10, 2014
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1184043853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TN · 56189
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
400 N STATE OF FRANKLIN RD FL 4, Johnson City, TN 37604
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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. Shivali M 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 ID6608165923
PECOS Enrollment IDI20171004002888
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 5

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 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.
326 services139 patients
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.
168 services84 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.
96 services93 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
28 services28 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
17 services17 patients

Hospital Affiliations CMS Care Compare

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

Johnson City Medical Center

Acute Care Hospitals · Johnson City, TN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440063
Location400 N State Of Franklin RdJohnson City, TN 37604 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37604 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%145 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.

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.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers15 claims15 services$61.22 avg. paid by Medicare
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
4 suppliers12 claims12 services$96.01 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

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

LEISA E MORRIS APRN-FNP
Nurse Practitioner (Family)
400 N STATE OF FRANKLIN RD FL 4
JOHNSON CITY, TN 37604
Washington County (423) 282-1480

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 Shivali Patel's NPI number?

The NPI number for Shivali Patel is 1184043853. It was assigned to this individual provider in the NPPES registry on April 10, 2014.

Where is Shivali Patel located?

Shivali Patel practices at 400 N State Of Franklin Rd Fl 4, Johnson City, TN 37604. The listed phone number is (423) 431-1961.

What is Shivali Patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shivali Patel enrolled in Medicare?

Yes. Shivali 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.

Is Shivali Patel affiliated with any hospitals?

According to CMS data, Shivali Patel is affiliated with Johnson City Medical Center.

When was this NPI record last updated?

The NPPES record for Shivali 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.