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SONA PARTH SADSELIA-PATEL DO
NPI 1285298992
Family Medicine in Middletown, CT

Active since April 29, 2019PECOS Enrolled
97.27/100
CMS Quality Rating
520 SAYBROOK ROAD SUITE N 100, MIDDLETOWN, CT 06457(860) 358-6486 Get Directions Write a Review

NPPES record last updated: September 14, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sona Parth Sadselia-patel Do NPPES

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

SONA PARTH SADSELIA-PATEL DO (NPI 1285298992) is an individual family medicine provider in Middletown, Connecticut, licensed in Connecticut (075413) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285298992
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSONA PARTH SADSELIA-PATELCredential: DO
Location Address520 SAYBROOK ROAD SUITE N 100Middletown, CT 06457-3649
Mailing Address28 Crescent StMiddletown, CT 06457-3650 · (860) 358-6000
Phone(860) 358-6486
Sole ProprietorNo
Enumeration DateApril 29, 2019
Last NPPES UpdateSeptember 14, 2023
NPPES CertifiedSeptember 14, 2023
✔ NPI 1285298992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CT · 075413
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
520 SAYBROOK ROAD SUITE N 100, Middletown, CT 06457
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sona Parth Sadselia-patel Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Sona Sadselia-patel reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mhs Primary Care
Same address
Family Medicine
520 SAYBROOK RD, SUITE N100
Middletown, CT 06457
  • Reassigned Medicare billing, Connecticut enrollment
  • 147 clinicians in this Medicare group
NPI 1639399959 (860) 344-1801
Middlesex Hospital
1.6 mi
Family
80 S MAIN ST
Middletown, CT 06457
  • Reassigned Medicare billing, Connecticut enrollment
  • 178 clinicians in this Medicare group
NPI 1972563138 (860) 358-6394

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.
54 services42 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.
51 services33 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.
18 services16 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
15 services15 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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06457 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

97.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.68
Promoting Interoperability100
Improvement Activities40

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 Sona Sadselia-patel's NPI number?

The NPI number for Sona Sadselia-patel is 1285298992. It was assigned to this individual provider in the NPPES registry on April 29, 2019.

Where is Sona Sadselia-patel located?

Sona Sadselia-patel practices at 520 Saybrook Road Suite N 100, Middletown, CT 06457. The listed phone number is (860) 358-6486.

What is Sona Sadselia-patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sona Sadselia-patel enrolled in Medicare?

Yes. Sona Sadselia-patel is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Sona Sadselia-patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sona Sadselia-patel reassigns Medicare benefits to 2 organizations: Mhs Primary Care (Middletown, CT) and Middlesex Hospital (Middletown, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sona Sadselia-patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sona Sadselia-patel accept?

Health plans from Blue Cross and Blue Shield of Texas list Sona Sadselia-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.

When was this NPI record last updated?

The NPPES record for Sona Sadselia-patel was last updated on September 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.