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HEMAL PATEL DO
NPI 1245626522
Internal Medicine in Hackensack, NJ

Active since April 13, 2015PECOS EnrolledAccepts Medicare Assignment
100 RIVER ST APT 246, HACKENSACK, NJ 07601(631) 372-1312(307) 204-7969 Get Directions Write a Review

NPPES record last updated: January 5, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 5, 2026, Jun 11, 2025, Jun 18, 2024 and 1 more (4 updates tracked since 2018).

About Hemal Patel Do NPPES

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

HEMAL PATEL DO (NPI 1245626522) is an individual internal medicine provider in Hackensack, New Jersey, licensed in New Jersey (25MB10933500) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1245626522
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameHEMAL PATELCredential: DO
Location Address100 RIVER ST APT 246Hackensack, NJ 07601-7451
Mailing Address100 River St Apt 246Hackensack, NJ 07601-7451 · (631) 372-1312 · Fax (307) 204-7969
Phone(631) 372-1312
Fax(307) 204-7969
Sole ProprietorYes
Medical School CMSTouro Un Col Of Osteopathic Medicine, New YorkGraduated 2015
Enumeration DateApril 13, 2015
Last NPPES UpdateJanuary 5, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 5, 2026
✔ NPI 1245626522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in NJ · 25MB10933500✔ Licensed in NY · 288730
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.
100 RIVER ST APT 246, Hackensack, NJ 07601
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1744 S Webster AveGreen Bay, WI 54301 · Phone (920) 433-3500
Location 2240 Meeting House LnSouthampton, NY 11968-5009 · Phone (631) 726-8200
Location 322303 DuPont BlvdGeorgetown, DE 19947-2153 · Phone (302) 440-4866

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare), Oscar Insurance Company.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

Hemal Patel Do 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 ID2860741006
PECOS Enrollment IDI20180821001282, I20210119001313, I20210617003021, I20211105000124
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 6

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
580 services352 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
406 services256 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
142 services142 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
127 services125 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
70 services68 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
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.
52 services28 patients

Hospital Affiliations CMS Care Compare 5

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

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310001
Location30 Prospect AveHackensack, NJ 07601 · Bergen County
Emergency services Birthing friendly

Good Samaritan Hospital Of Suffern

Acute Care Hospitals · Suffern, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number330158
Location255 Lafayette AvenueSuffern, NY 10901 · Rockland County
Emergency services Birthing friendly

Phelps Hospital

Acute Care Hospitals · Sleepy Hollow, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330261
Location701 N BroadwaySleepy Hollow, NY 10591 · Westchester County
Emergency services Birthing friendly

Hudson Valley Hospital Center

Acute Care Hospitals · Cortlandt Manor, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330267
Location1980 Crompond RoadCortlandt Manor, NY 10567 · Westchester County
Emergency services Birthing friendly

White Plains Hospital Center

Acute Care Hospitals · White Plains, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330304
Location41 East Post R0adWhite Plains, NY 10601 · Westchester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07601 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers11 claims11 services$15.14 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers28 claims28 services$65.09 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
3 suppliers16 claims16 services$31.35 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

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

DRONCALL MEDICAL GROUP NJ LLC
Internal Medicine
100 RIVER ST APT 246
HACKENSACK, NJ 07601
Bergen County (631) 372-1312

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 Hemal Patel's NPI number?

The NPI number for Hemal Patel is 1245626522. It was assigned to this individual provider in the NPPES registry on April 13, 2015.

Where is Hemal Patel located?

Hemal Patel practices at 100 River St Apt 246, Hackensack, NJ 07601. The listed phone number is (631) 372-1312.

What is Hemal Patel's specialty?

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

Is Hemal Patel enrolled in Medicare?

Yes. Hemal 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 Hemal Patel accept?

Health plans from CareSource (Common Ground Healthcare) and Oscar Insurance Company list Hemal 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 Hemal Patel affiliated with any hospitals?

According to CMS data, Hemal Patel is affiliated with Hackensack University Medical Center, Good Samaritan Hospital Of Suffern, Phelps Hospital, Hudson Valley Hospital Center and White Plains Hospital Center.

When was this NPI record last updated?

The NPPES record for Hemal Patel was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.