KRUNAL MANUBHAI PATEL MD
NPI 1235393059
Internal Medicine - Nephrology in Portsmouth, VA
Active since July 10, 2008PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
3235 ACADEMY AVE, SUITE 301, PORTSMOUTH, VA 23703(757) 484-9400(757) 484-8809 Get Directions Write a Review
About Krunal Manubhai Patel Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KRUNAL MANUBHAI PATEL MD (NPI 1235393059) is an individual nephrology provider in Portsmouth, Virginia, licensed in Virginia (0101253844) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Bon Secours Maryview Medical Center, and is a graduate of Other (2004).
NPPES Registry Identity
NPI1235393059
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameKRUNAL MANUBHAI PATELCredential: MD
Location Address3235 ACADEMY AVE, SUITE 301Portsmouth, VA 23703-3200
Mailing Address3235 Academy Ave, Suite 301Portsmouth, VA 23703-3200 · (757) 484-9400 · Fax (757) 484-8809
Phone(757) 484-9400
Fax(757) 484-8809
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateJuly 10, 2008
Last NPPES UpdateMay 11, 20202 updates tracked since enumeration
NPPES CertifiedMay 11, 2020
✔ NPI 1235393059 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in VA · 0101253844
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
3235 ACADEMY AVE, Portsmouth, VA 23703
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
Krunal Manubhai 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 ID4880836691
PECOS Enrollment IDI20130807000565
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 15
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.
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
2,349 services141 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
1,915 services127 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
1,202 services150 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
1,101 services139 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
1,050 services132 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.
407 services213 patients
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Bon Secours Maryview Medical Center
Acute Care Hospitals · Portsmouth, VAOwnershipVoluntary non-profit - Private
CMS Certification Number490017
Location3636 High StreetPortsmouth, VA 23707 · Portsmouth City County
Emergency services
Sentara Obici Hospital
Acute Care Hospitals · Suffolk, VAOwnershipVoluntary non-profit - Other
CMS Certification Number490044
Location2800 Godwin BoulevardSuffolk, VA 23439 · Suffolk City County
Emergency services Birthing friendly
Riverside Regional Medical Center
Acute Care Hospitals · Newport News, VAOwnershipVoluntary non-profit - Private
CMS Certification Number490052
Location500 J Clyde Morris BlvdNewport News, VA 23601 · Newport News City County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 23703 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.
75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scoredReported Quality Measures
Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
94%1,194 patients4/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
66%56 patients3/55-star benchmark: 95%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
94%5,192 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
92%964 patients4/55-star benchmark: 100%
Patient-Generated Health Data
Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.
61%895 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
98%895 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
33%334 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%510 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 357 patients
Patients tobacco: 99% · 357 patients
97%30 patients4/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
97%895 patients4/55-star benchmark: 100%
Request/Accept Summary of Care
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…
0%1,194 patients1/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
0%895 patients1/55-star benchmark: 75%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 334 patients
0%334 patients5/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
1%895 patients
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 5
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Azathioprine, oral, 50 mg J7500
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier13 claims390 services$1.06 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers26 claims5,850 services$0.32 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier13 claims1,770 services$0.83 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
2 suppliers24 claims24 services$18.15 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
2 suppliers32 claims32 services$12.25 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Nurse Practitioner
3235 ACADEMY AVE, SUITE 305
PORTSMOUTH, VA 23703
PORTSMOUTH, VA 23703
Colon & Rectal Surgery
3235 ACADEMY AVE, SUITE 200
PORTSMOUTH, VA 23703
PORTSMOUTH, VA 23703
Internal Medicine (Nephrology)
3235 ACADEMY AVE, STE 301
PORTSMOUTH, VA 23703
PORTSMOUTH, VA 23703
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
3235 ACADEMY AVE, SUITE 200
PORTSMOUTH, VA 23703
PORTSMOUTH, VA 23703
Internal Medicine (Cardiovascular Disease)
3235 ACADEMY AVE, SUITE 201
PORTSMOUTH, VA 23703
PORTSMOUTH, VA 23703
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 Krunal Patel's NPI number?
The NPI number for Krunal Patel is 1235393059. It was assigned to this individual provider in the NPPES registry on July 10, 2008.
Where is Krunal Patel located?
Krunal Patel practices at 3235 Academy Ave Suite 301, Portsmouth, VA 23703. The listed phone number is (757) 484-9400.
What is Krunal Patel's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Krunal Patel enrolled in Medicare?
Yes. Krunal 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 Krunal Patel affiliated with any hospitals?
According to CMS data, Krunal Patel is affiliated with Bon Secours Maryview Medical Center, Sentara Obici Hospital and Riverside Regional Medical Center.
When was this NPI record last updated?
The NPPES record for Krunal Patel was last updated on May 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Krunal Manubhai Patel, MD · NPI 1235393059
Nephrology physician in Portsmouth, Virginia. Individual provider, active in the CMS NPPES registry since July 10, 2008.
## Identity
- **NPI:** 1235393059 (Entity type: Individual)
- **Enumerated:** July 10, 2008
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **State license:** 0101253844 (Virginia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3235 ACADEMY AVE, SUITE 301, Portsmouth, VA 23703-3200
- **Phone:** (757) 484-9400 · **Fax:** (757) 484-8809
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2004
## Record status
- **NPPES last updated:** May 11, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1235393059) · Data from the CMS NPPES public registry.