1. Home
  2. Directory
  3. Ohio
  4. Granville
  5. Family Medicine
  6. NPI Profile

PRIT PATEL MD
NPI 1205576469
Family Medicine in Granville, OH

Active since March 29, 2022PECOS EnrolledAccepts Medicare Assignment
90.5/100
CMS Quality Rating
1264 WEAVER DR, GRANVILLE, OH 43023(220) 564-1961(220) 564-1959 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 16, 2025, Jul 9, 2025, Dec 17, 2024 and 2 more (5 updates tracked since 2023).

About Prit Patel Md NPPES

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

PRIT PATEL MD (NPI 1205576469) is an individual family medicine provider in Granville, Ohio, licensed in Ohio (35.149254) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, is affiliated with Licking Memorial Hospital, and maintains a secondary practice location in Dublin.

NPPES Registry Identity

NPI1205576469
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NamePRIT PATELCredential: MD
Location Address1264 WEAVER DRGranville, OH 43023-1257
Mailing Address1264 Weaver DrGranville, OH 43023-1257 · (220) 564-1961 · Fax (220) 564-1959
Phone(220) 564-1961
Fax(220) 564-1959
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2022
Enumeration DateMarch 29, 2022
Last NPPES UpdateSeptember 16, 20255 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2025
✔ NPI 1205576469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 35.149254
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1264 WEAVER DR, Granville, OH 43023
Open in Google Maps ↗

Secondary Practice Location 1

Location 16905 Hospital Dr Ste 130Dublin, OH 43016-9600 · Phone (614) 923-0300 · Fax (614) 923-0400

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, AvMed, Florida Blue (BlueCross BlueShield FL) 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

Prit 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 ID3678950003
PECOS Enrollment IDI20231017002270
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 Reassignments

7

Medicare enrollment records show Prit Patel reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Licking Memorial Professional Corporation
4.0 mi
Anatomic Pathology & Clinical Pathology
1320 W MAIN ST
Newark, OH 43055
  • Reassigned Medicare billing, Ohio enrollment
  • Medicare enrollment name: Licking Memorial Health Professionals
  • 280 clinicians in this Medicare group
NPI 1932186053 (740) 348-4266
Ohiohealth Urgent Care LLC
34 mi
Urgent Care
6905 HOSPITAL DR STE 130
Dublin, OH 43016
  • Reassigned Medicare billing, Ohio enrollment
  • 388 clinicians in this Medicare group
NPI 1811207160 (614) 923-0300
St. Vincent Medical Group, Inc.
122 mi
Rural Health
330 W DEERFIELD RD
Union City, IN 47390
  • Reassigned Medicare billing, Indiana enrollment
  • 945 clinicians in this Medicare group
NPI 1871866384 (765) 964-6200
Ascension Medical Group-Southeast Wisconsin Inc
346 mi
Anesthesiology
2301 N LAKE DR
Milwaukee, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,343 clinicians in this Medicare group
NPI 1194473066 (414) 585-1000
Saint Thomas Medical Partners
356 mi
Internal Medicine
2011 MURPHY AVE, SUITE 301
Nashville, TN 37203
  • Reassigned Medicare billing, Tennessee enrollment
  • 1,304 clinicians in this Medicare group
NPI 1437194669 (615) 327-9543
St Vincents Ambulatory Care Inc
673 mi
Neurological Surgery
2 SHIRCLIFF WAY, SUITE 600
Jacksonville, FL 32204
  • Reassigned Medicare billing, Florida enrollment
  • Medicare enrollment name: St Vincent's Ambulatory Care Inc
  • 544 clinicians in this Medicare group
NPI 1417987124 (904) 308-6769
Sacred Heart Health System, Inc.
711 mi
Primary Care
5225 CARMEL HEIGHTS DR
Pensacola, FL 32504
  • Reassigned Medicare billing, Florida enrollment
  • 446 clinicians in this Medicare group
NPI 1043261498 (850) 475-4500

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

Hospital Affiliations CMS Care Compare

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

Licking Memorial Hospital

Acute Care Hospitals · Newark, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360218
Location1320 West Main StreetNewark, OH 43055 · Licking County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43023 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

90.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality90.75
Promoting Interoperability100
Improvement Activities40
Cost77.59

Other Providers at the Same Location NPPES 5

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

LICKING MEMORIAL PROFESSIONAL CORPORATION
Family Medicine
1264 WEAVER DR
GRANVILLE, OH 43023
Licking County (740) 348-1940
KALPANA JONES M.D.
Family Medicine
1264 WEAVER DR
GRANVILLE, OH 43023
Licking County (220) 564-1961
DR. MICHAEL D BARTH MD
Family Medicine
1264 WEAVER DR
GRANVILLE, OH 43023
Licking County (220) 564-1940
KEVIN T GRAHAM M.D.
Family Medicine
1264 WEAVER DR
GRANVILLE, OH 43023
Licking County (220) 564-1950
AARON J KIBLER MD
Family Medicine
1264 WEAVER DR
GRANVILLE, OH 43023
Licking County (220) 564-1955

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 Prit Patel's NPI number?

The NPI number for Prit Patel is 1205576469. It was assigned to this individual provider in the NPPES registry on March 29, 2022.

Where is Prit Patel located?

Prit Patel practices at 1264 Weaver Dr, Granville, OH 43023. The listed phone number is (220) 564-1961.

What is Prit Patel's specialty?

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

Is Prit Patel enrolled in Medicare?

Yes. Prit 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 organizations bill Medicare for Prit Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prit Patel reassigns Medicare benefits to 7 organizations: Licking Memorial Professional Corporation (Newark, OH), Ohiohealth Urgent Care LLC (Dublin, OH), St. Vincent Medical Group, Inc. (Union City, IN), Ascension Medical Group-Southeast Wisconsin Inc (Milwaukee, WI), Saint Thomas Medical Partners (Nashville, TN) and 2 more organizations, listed in the Medicare section above. Each 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 Prit Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Prit Patel accept?

Health plans from Anthem Blue Cross and Blue Shield, AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and MedMutual and 2 other insurers list Prit 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 Prit Patel affiliated with any hospitals?

According to CMS data, Prit Patel is affiliated with Licking Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Prit Patel was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.