NIRAV Y PATEL MD
NPI 1215939566
Surgery - Trauma Surgery in Phoenix, AZ
NPI Status: Active since June 01, 2005
Contact Information
1441 N 12TH ST FL 1
PHOENIX, AZ
ZIP 85006
Phone: (608) 385-1303
- Individual
- Male
- Years of Experience 34
- Surgery
- Trauma Surgery
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About NIRAV PATEL
This page provides the complete NPI Profile along with additional information for Nirav Patel, a provider established in Phoenix, Arizona with a medical specialization in Surgery, focusing in trauma surgery and more than 34 years of experience. He graduated from University Of Wisconsin School Of Medicine in 1992. The healthcare provider is registered in the NPI registry with number 1215939566 assigned on June 2005. The practitioner's primary taxonomy code is 2086S0127X with license number 45334 (AZ). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1215939566
- Provider Name
- NIRAV Y PATEL MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1441 N 12TH ST FL 1 PHOENIX, AZ 85006
- Location Phone
- (608) 385-1303
- Mailing Address
- 1836 SOUTH AVE LA CROSSE, WI 54601
- Mailing Phone
- (608) 782-7300
- Medical School Name
- UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
- Graduation Year
- 1992
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-01-2005
- Last Update Date
- 11-20-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery Trauma Surgery
- Taxonomy Code
- 2086S0127X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 45334
- License State
- AZ
- Taxonomy Description
- Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AZ Blue ACA StandardHealth Silver with Health Choice - HMO
- AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Bronze Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Silver Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Gold Neighborhood (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Prosano Gold ($0 Prosano Health Visits) - HMO
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Simple - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Buena Salud Bronce Simple Para Diabetes - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Gold Simple - HMO
- Gold Simple Diabetes - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value HSA (No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0492 | MEDICARE PIN (08) | WI | |
| Z148786 | MEDICARE PIN (08) | AZ | |
| Z148785 | MEDICARE PIN (08) | AZ | |
| G76600 | MEDICARE UPIN (02) | ||
| Z148784 | MEDICARE PIN (08) | AZ |
Medicare Participation & PECOS Enrollment Status
Nirav Patel is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Nirav Patel is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 9537292693
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20111202000694
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Follow-up hospital inpatient care per day, typically 15 minutes
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
This service was performed 11 times for 11 patientsReviews for NIRAV Y PATEL MD
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1215939566, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
PHOENIX, AZ 85006
PHOENIX, AZ 85006
PHOENIX, AZ 85006
PHOENIX, AZ 85006
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215939566, enumerated as an "individual" on June 01, 2005.
The provider is located at 1441 N 12TH ST FL 1 PHOENIX, AZ 85006 and the phone number is (608) 385-1303.
Surgery with taxonomy code 2086S0127X and a focus in Trauma Surgery.
The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.