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DR. SHIVAM GIRISH PATEL M.D.
NPI 1285074013
Internal Medicine - Endocrinology, Diabetes & Metabolism in Smyrna, GA

Active since June 25, 2013PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
4441 ATLANTA RD SE STE 212, SMYRNA, GA 30080(470) 956-4100 Get Directions Write a Review

NPPES record last updated: October 7, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 7, 2019, Jan 8, 2019, Dec 7, 2018 (3 updates tracked since 2018).

About Dr. Shivam Girish Patel M.d. NPPES

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

DR. SHIVAM GIRISH PATEL M.D. (NPI 1285074013) is an individual endocrinology, diabetes & metabolism provider in Smyrna, Georgia, licensed in Georgia (81612) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and maintains a secondary practice location in Decatur.

NPPES Registry Identity

NPI1285074013
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameDR. SHIVAM GIRISH PATELCredential: M.D.
Location Address4441 ATLANTA RD SE STE 212Smyrna, GA 30080-6442
Mailing Address4157 Fischer WayAtlanta, GA 30341-1454
Phone(470) 956-4100
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJune 25, 2013
Last NPPES UpdateOctober 7, 20193 updates tracked since enumeration
✔ NPI 1285074013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in GA · 81612
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedInternal MedicineTaxonomy 207R00000X · License 081612 (GA), MT205246 (PA)
Also ListedHospitalistTaxonomy 208M00000X · License 081612 (GA)
4441 ATLANTA RD SE STE 212, Smyrna, GA 30080
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Secondary Practice Location 1

Location 12701 N Decatur RdDecatur, GA 30033 · Phone (404) 501-1000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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. Shivam Girish 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 ID8628320199
PECOS Enrollment IDI20190212002107
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.

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.
326 services176 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
204 services99 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
103 services75 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
94 services44 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
20 services17 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.
19 services19 patients

Hospital Affiliations CMS Care Compare 5

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110035
Location677 Church StreetMarietta, GA 30060 · Cobb County
Emergency services Birthing friendly

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110042
Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110143
Location3950 Austell RdAustell, GA 30106 · Cobb County
Birthing friendly

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110184
Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County
Emergency services Birthing friendly

Wellstar North Fulton Hospital

Acute Care Hospitals · Roswell, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110198
Location3000 Hospital BoulevardRoswell, GA 30076 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30080 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
37 suppliers100 claims305 services$6.28 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
20 suppliers32 claims50 services$1.05 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
7 suppliers228 claims228 services$186.66 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Shivam Patel's NPI number?

The NPI number for Shivam Patel is 1285074013. It was assigned to this individual provider in the NPPES registry on June 25, 2013.

Where is Shivam Patel located?

Shivam Patel practices at 4441 Atlanta Rd SE Ste 212, Smyrna, GA 30080. The listed phone number is (470) 956-4100.

What is Shivam Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Shivam Patel enrolled in Medicare?

Yes. Shivam 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 Shivam Patel accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Shivam 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 Shivam Patel affiliated with any hospitals?

According to CMS data, Shivam Patel is affiliated with Wellstar Kennestone Regional Medical Center, Wellstar Paulding Medical Center, Wellstar Cobb Medical Center, Wellstar Douglas Medical Center and Wellstar North Fulton Hospital.

When was this NPI record last updated?

The NPPES record for Shivam Patel was last updated on October 7, 2019. 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.