DR. ACHAL PATEL M.D.
NPI 1265723019
Neurological Surgery in Edinburg, TX

Q: What is Achal Patel's NPI number?

The NPI number for Achal Patel is 1265723019. It was assigned to this individual provider in the NPPES registry on April 27, 2011.

Q: What is Achal Patel's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Q: When was this NPI record last updated?

The NPPES record for Achal Patel was last updated on July 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 27, 2011PECOS EnrolledAccepts Medicare Assignment

92.53/100

CMS Quality Rating

5519 DOCTORS DR, EDINBURG, TX 78539(956) 362-8500(956) 362-8505 Get Directions Write a Review

NPPES record last updated: July 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 11, 2024, Nov 8, 2023, Mar 23, 2023 and 4 more (7 updates tracked since 2018).

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About Dr. Achal Patel M.d. NPPES

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

DR. ACHAL PATEL M.D. (NPI 1265723019) is an individual neurological surgery provider in Edinburg, Texas, licensed in Texas (R4302) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS, is affiliated with Knapp Medical Center, and is a graduate of University Of Arkansas College Of Medicine (2011).

NPPES Registry Identity

NPI1265723019

Entity TypeIndividualMale

Primary Taxonomy207T00000X

Provider Legal NameDR. ACHAL PATELCredential: M.D.

Location Address5519 DOCTORS DREdinburg, TX 78539-5563

Mailing AddressPo Box 749Pharr, TX 78577-1614 · (956) 362-8500 · Fax (956) 362-8505

Phone(956) 362-8500

Fax(956) 362-8505

Sole ProprietorNo

Medical School CMSUniversity Of Arkansas College Of MedicineGraduated 2011

Enumeration DateApril 27, 2011

Last NPPES UpdateJuly 11, 20247 updates tracked since enumeration

NPPES CertifiedJuly 11, 2024

✔ NPI 1265723019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207T00000X

License✔ Licensed in TX · R4302

Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

5519 DOCTORS DR, Edinburg, TX 78539

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Other Identifiers 1

OtherBP1-0040984TX · Utmb Postgraduate Training Permit

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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. Achal Patel M.d. 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 ID1355620527

PECOS Enrollment IDI20180604002027

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 5

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 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.

52 services39 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.

32 services23 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

24 services24 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

14 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

13 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Knapp Medical Center

Acute Care Hospitals · Weslaco, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450128

Location1401 East Eight StreetWeslaco, TX 78596 · Hidalgo County

Emergency services Birthing friendly

Doctors Hosptal At Renaissance

Acute Care Hospitals · Edinburg, TX

3/5 CMS rating

OwnershipPhysician

CMS Certification Number450869

Location5501 South MccollEdinburg, TX 78539 · Hidalgo County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78539 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

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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.

92.53/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

79.45

Improvement Activities

Other Providers at the Same Location NPPES 10

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

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