MR. PRANAY R. PATEL M.D.
NPI 1194729715
Internal Medicine in Spartanburg, SC

Q: What is Pranay Patel's NPI number?

The NPI number for Pranay Patel is 1194729715. It was assigned to this individual provider in the NPPES registry on June 10, 2005.

Q: What is Pranay Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Pranay Patel was last updated on August 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 10, 2005PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

3070 REIDVILLE RD, SPARTANBURG, SC 29301(864) 576-5764(864) 587-3969 Get Directions Write a Review

NPPES record last updated: August 9, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Mr. Pranay R. Patel M.d. NPPES

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

MR. PRANAY R. PATEL M.D. (NPI 1194729715) is an individual internal medicine provider in Spartanburg, South Carolina, licensed in South Carolina (20947) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Spartanburg Medical Center, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1194729715

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMR. PRANAY R. PATELCredential: M.D.

Location Address3070 REIDVILLE RDSpartanburg, SC 29301

Mailing Address3070 Reidville Rd, P O Box170156Spartanburg, SC 29301 · (864) 576-5764 · Fax (864) 587-3969

Phone(864) 576-5764

Fax(864) 587-3969

Sole ProprietorYes

Medical School CMSOtherGraduated 1988

Enumeration DateJune 10, 2005

Last NPPES UpdateAugust 9, 2024

NPPES CertifiedAugust 9, 2024

✔ NPI 1194729715 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in SC · 20947

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

3070 REIDVILLE RD, Spartanburg, SC 29301

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Other Identifiers 2

MedicaidGP4622SC

Medicaid209474SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Pranay R. 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 ID6901908391

PECOS Enrollment IDI20070305000333

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.

Medicare Billing Reassignment

Medicare enrollment records show Pranay Patel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Westside Internal Medicine, LLC

Same address

Internal Medicine

3070 REIDVILLE RD
Spartanburg, SC 29301

Reassigned Medicare billing, South Carolina enrollment
4 clinicians in this Medicare group

NPI 1134279961 (864) 587-3180

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 24

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.

503 services147 patients

Testing for presence of drug, read by direct observation 80305

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

232 services55 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.

194 services84 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

147 services51 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

136 services25 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

116 services24 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

88 services87 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

86 services86 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

85 services84 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

80 services80 patients

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes G0446

This is a yearly, personal consultation focused on behaviors affecting heart health. It lasts 15 minutes and may cover topics like diet, exercise, and stress management. It's about learning healthy habits to protect your heart.

80 services80 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

79 services13 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

73 services72 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

33 services33 patients

Annual alcohol misuse screening, 5 to 15 minutes G0442

An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.

31 services31 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

30 services22 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

27 services27 patients

Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous G0328

A fecal occult blood test is a screening tool for colorectal cancer. It checks for tiny amounts of blood in your stool that can't be seen with the naked eye. The immunoassay method can test 1-3 samples at once. This helps detect cancer early, when treatment is most effective.

24 services24 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

22 services17 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

19 services19 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

17 services13 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment 95250

This process involves a tiny sensor placed under your skin that checks your blood sugar levels in tissue fluid regularly. The sensor sends these readings to a device, allowing you to track your levels in real-time. This is provided by your healthcare provider.

14 services11 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

14 services11 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

13 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Spartanburg Medical Center

Acute Care Hospitals · Spartanburg, SC

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420007

Location101 E Wood StSpartanburg, SC 29303 · Spartanburg County

Emergency services Birthing friendly

Pelham Medical Center

Acute Care Hospitals · Greer, SC

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420103

Location250 Westmoreland RoadGreer, SC 29651 · Greenville County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29301 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

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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.

100/100

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

Individually scored

Quality

100

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Advance Care Plan

100%416 patients5/55-star benchmark: 100%

Controlling High Blood Pressure

93%422 patients4/55-star benchmark: 98%

Coronary Artery Disease (CAD): Antiplatelet Therapy

100%54 patients5/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

6%239 patients4/55-star benchmark: 98%

Documentation of Current Medications in the Medical Record

98%3,843 patients4/55-star benchmark: 100%

e-Prescribing

98%2,039 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

91%403 patients4/55-star benchmark: 100%

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

100%938 patients5/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

86%505 patients4/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

93%151 patients4/55-star benchmark: 98%

Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older

100%32 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 13

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

13 suppliers46 claims152 services$6.37 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

2 suppliers12 claims12 services$2.95 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers19 claims43 services$1.13 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

4 suppliers12 claims12 services$35.71 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

5 suppliers19 claims19 services$79.26 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

5 suppliers24 claims58 services$32.55 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 3

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

LATOYA RAQUEL SHELTON FNP-C

Nurse Practitioner (Family)

3070 REIDVILLE RD
SPARTANBURG, SC 29301

Spartanburg County (864) 576-5764

WESTSIDE INTERNAL MEDICINE, LLC

Internal Medicine

3070 REIDVILLE RD
SPARTANBURG, SC 29301

Spartanburg County (864) 587-3180

SHAREDA MICKELLE YOUNG NP

Nurse Practitioner (Adult Health)

3070 REIDVILLE RD
SPARTANBURG, SC 29301

Spartanburg County (864) 576-5764

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 Pranay Patel's NPI number?

The NPI number for Pranay Patel is 1194729715. It was assigned to this individual provider in the NPPES registry on June 10, 2005.

Where is Pranay Patel located?

Pranay Patel practices at 3070 Reidville Rd, Spartanburg, SC 29301. The listed phone number is (864) 576-5764.

What is Pranay Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pranay Patel enrolled in Medicare?

Yes. Pranay 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.

Which organization bills Medicare for Pranay Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pranay Patel reassigns Medicare benefits to Westside Internal Medicine, LLC (Spartanburg, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pranay Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pranay Patel accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and InStil Health and 2 other insurers list Pranay 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 Pranay Patel affiliated with any hospitals?

According to CMS data, Pranay Patel is affiliated with Spartanburg Medical Center and Pelham Medical Center.

When was this NPI record last updated?

The NPPES record for Pranay Patel was last updated on August 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.