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DR. PRINA PATEL OD
NPI 1205568797
Optometrist in Parkton, MD

Active since June 24, 2022PECOS EnrolledAccepts Medicare Assignment
86.09/100
CMS Quality Rating
111 MOUNT CARMEL RD STE 600, PARKTON, MD 21120(410) 329-6700 Get Directions Write a Review

NPPES record last updated: July 22, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Prina Patel Od NPPES

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

DR. PRINA PATEL OD (NPI 1205568797) is an individual optometrist in Parkton, Maryland, licensed in Maryland (TA2854) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1205568797
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. PRINA PATELCredential: OD
Location Address111 MOUNT CARMEL RD STE 600Parkton, MD 21120-9796
Mailing Address111 Mount Carmel Rd Ste 600Parkton, MD 21120-9796 · (410) 329-6700
Phone(410) 329-6700
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJune 24, 2022
Last NPPES UpdateJuly 22, 2022
NPPES CertifiedJuly 22, 2022
✔ NPI 1205568797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in MD · TA2854
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.
111 MOUNT CARMEL RD STE 600, Parkton, MD 21120
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Accepted Insurance

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

Dr. Prina Patel Od 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 ID9335520543
PECOS Enrollment IDI20220720000191
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 8

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 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.
205 services205 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.
91 services83 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.
78 services74 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
73 services73 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.
23 services22 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
22 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21120 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.

86.09/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.89
Promoting Interoperability85
Improvement Activities40

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 Prina Patel's NPI number?

The NPI number for Prina Patel is 1205568797. It was assigned to this individual provider in the NPPES registry on June 24, 2022.

Where is Prina Patel located?

Prina Patel practices at 111 Mount Carmel Rd Ste 600, Parkton, MD 21120. The listed phone number is (410) 329-6700.

What is Prina Patel's specialty?

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

Is Prina Patel enrolled in Medicare?

Yes. Prina 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 Prina Patel accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Prina 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 Prina Patel was last updated on July 22, 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.