SACHIN S PATEL M.D.
NPI 1285024935
Internal Medicine - Nephrology in Somerset, NJ

NPI Status: Active since February 03, 2015

Contact Information

23 CLYDE RD STE 101
SOMERSET, NJ
ZIP 08873
Phone: (732) 873-9500
Fax: (732) 873-0261

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  • Individual
  • Male
  • Years of Experience 8
  • Internal Medicine
  • Nephrology
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About SACHIN PATEL

This page provides the complete NPI Profile along with additional information for Sachin Patel, an internist established in Somerset, New Jersey with a medical specialization in Internal Medicine, focusing in nephrology and more than 8 years of experience. The healthcare provider is registered in the NPI registry with number 1285024935 assigned on February 2015. The practitioner's primary taxonomy code is 207RN0300X with license number 25MA1008200 (NJ). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1285024935
Provider Name
SACHIN S PATEL M.D.
Gender
Male
Entity Type
Individual
Location Address
23 CLYDE RD STE 101 SOMERSET, NJ 08873
Location Phone
(732) 873-9500
Location Fax
(732) 873-0261
Mailing Address
23 CLYDE RD STE 101 SOMERSET, NJ 08873
Mailing Phone
(917) 714-4431
Mailing Fax
(732) 873-0261
Medical School Name
OTHER
Graduation Year
2018
Is Sole Proprietor?
No
Enumeration Date
02-03-2015
Last Update Date
06-04-2020
Code Navigator

An internist like Sachin Patel is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Secondary Locations

  • 125 Paterson Street One RWJ Place, Department of Medicine: MEB 484 C
    NEW BRUNSWICK, NJ 08901
    (732) 235-8909

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

Internal Medicine Nephrology

Taxonomy Code
207RN0300X
Type
Allopathic & Osteopathic Physicians
License No.
25MA1008200
License State
NJ
Taxonomy Description
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.

Medicare Participation & PECOS Enrollment Status

Sachin 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.

Sachin 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: 6507139672

    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: I20170912002050

    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.

Advance care planning, first 30 minutes

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.

This service was performed 13 times for 12 patients

Critical care, first 30-74 minutes

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

This service was performed 100 times for 46 patients

Dialysis procedure requiring repeat evaluation

Dialysis is a treatment that filters waste and excess water from your blood, mimicking the function of healthy kidneys. Repeat evaluations are necessary to monitor your body's response to the treatment, ensuring it's working effectively and adjusting as needed for optimal health.

This service was performed 31 times for 12 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 1,149 times for 328 patients

Follow-up hospital inpatient care per day, typically 35 minutes

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.

This service was performed 1,146 times for 274 patients

Hemodialysis procedure requiring repeated evaluation

Hemodialysis is a treatment that filters waste and excess fluids from your blood when your kidneys can't do this adequately. It's an ongoing process, requiring regular evaluations to monitor and adjust the treatment for optimal results.

This service was performed 88 times for 41 patients

Initial hospital inpatient care per day, typically 50 minutes

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.

This service was performed 88 times for 86 patients

Initial hospital inpatient care per day, typically 70 minutes

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.

This service was performed 165 times for 153 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $36.21 for a new patient copayment and $27.89 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 08873 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $144.86
  • Minimum New Patient Price $63.84
  • Maximum New Patient Price $190.92
  • Average New Patient Copayment $36.21
  • Minimum New Patient Copayment $15.96
  • Maximum New Patient Copayment $47.73

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $111.57
  • Minimum Established Patient Price $20.97
  • Maximum Established Patient Price $155.92
  • Average Established Patient Copayment $27.89
  • Minimum Established Patient Copayment $5.24
  • Maximum Established Patient Copayment $38.98

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Care Plan 89% 65
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Diabetes: Medical Attention for Nephropathy 97% 29
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record 99% 118
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of New Medicaid Patients and Follow-upYesN/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
Engagement of Patients, Family, and Caregivers in Developing a Plan of CareYesN/A
Engage patients, family, and caregivers in developing a plan of care and prioritizing their goals for action, documented in the electronic health record (EHR) technology.
Implementation of condition-specific chronic disease self-management support programsYesN/A
Provide condition-specific chronic disease self-management support programs or coaching or link patients to those programs in the community.
Pneumococcal Vaccination Status for Older Adults 17% 66
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 25% 100
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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Influenza Immunization 53% 57
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Use of High-Risk Medications in the Elderly 0% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
66
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. 2) Percentage of patients who were ordered at least two of the same high-risk medication

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sachin Patel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ROBERT WOOD JOHNSON UNIVERSITY HOSPITALONE ROBERT WOOD JOHNSON PLACE
NEW BRUNSWICK, NJ 08901
(732) 828-3000Acute Care Hospitals
ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - SOMERSET110 REHILL AVE
SOMERVILLE, NJ 08876
(908) 685-2200Acute Care Hospitals
SAINT PETER'S UNIVERSITY HOSPITAL254 EASTON AVE
NEW BRUNSWICK, NJ 08901
(732) 745-8600Acute Care Hospitals

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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 1285024935, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
5
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
4
Doubled → 8
Pos 8
9
Unchanged
Pos 9
3
Doubled → 6
Check
5
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 8 → 16 → 7 0 → 0 4 → 8 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 6 + 5 + 0 + 2 + 8 + 9 + 6 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1285024935.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Internal Medicine (Nephrology)
23 CLYDE RD STE 101
SOMERSET, NJ 08873

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285024935, enumerated as an "individual" on February 03, 2015.

The provider is located at 23 CLYDE RD STE 101 SOMERSET, NJ 08873 and the phone number is (732) 873-9500.

Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.

Sachin Patel is affiliated with: ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL, ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - SOMERSET and SAINT PETER'S UNIVERSITY HOSPITAL.