DR. SAPAN PATEL MD
NPI 1295075661
Internal Medicine - Critical Care Medicine in Austin, TX

Q: What is Sapan Patel's NPI number?

The NPI number for Sapan Patel is 1295075661. It was assigned to this individual provider in the NPPES registry on February 22, 2013.

Q: What is Sapan Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for Sapan Patel was last updated on July 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 February 22, 2013PECOS EnrolledAccepts Medicare Assignment

80.78/100

CMS Quality Rating

5920 W WILLIAM CANNON DR STE 150, AUSTIN, TX 78749(512) 977-0123(512) 977-0126 Get Directions Write a Review

NPPES record last updated: July 18, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Sapan Patel Md NPPES

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

DR. SAPAN PATEL MD (NPI 1295075661) is an individual critical care medicine provider in Austin, Texas, licensed in Texas (S2868) and active in the NPI registry since February 2013. He is enrolled in Medicare PECOS, is affiliated with St David's Medical Center, and maintains a secondary practice location in Brooklyn.

NPPES Registry Identity

NPI1295075661

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameDR. SAPAN PATELCredential: MD

Location Address5920 W WILLIAM CANNON DR STE 150Austin, TX 78749

Mailing Address5920 W William Cannon Dr Ste 150Austin, TX 78749-1902 · (512) 977-0123 · Fax (512) 977-0126

Phone(512) 977-0123

Fax(512) 977-0126

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateFebruary 22, 2013

Last NPPES UpdateJuly 18, 2019

✔ NPI 1295075661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

License✔ Licensed in TX · S2868

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedInternal MedicineTaxonomy 207R00000X · License S2868 (TX)

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License S2868 (TX)

5920 W WILLIAM CANNON DR STE 150, Austin, TX 78749

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Secondary Practice Location 1

Location 1506 6th StBrooklyn, NY 11215-3609 · Phone (510) 386-6826

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. Sapan Patel Md 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 ID9931436078

PECOS Enrollment IDI20190812002603

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 15

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.

Critical care, first 30-74 minutes 99291

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.

200 services88 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.

181 services139 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.

145 services80 patients

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.

111 services59 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

74 services43 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

69 services13 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

68 services11 patients

Test to measure rate of airflow 94375

This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.

48 services47 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

47 services45 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

47 services45 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.

39 services39 patients

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.

24 services24 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.

17 services17 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

14 services14 patients

Emergent insertion of breathing tube into windpipe using an endoscope 31500

This is a procedure where a thin tube is inserted into your windpipe to aid in breathing. It's done in emergency situations, using an endoscope, a tool with a light and camera, to ensure correct placement.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

St David's Medical Center

Acute Care Hospitals · Austin, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450431

Location919 E 32nd StAustin, TX 78705 · Travis County

Emergency services Birthing friendly

Round Rock Medical Center

Acute Care Hospitals · Round Rock, TX

4/5 CMS rating

OwnershipProprietary

CMS Certification Number450718

Location2400 Round Rock AveRound Rock, TX 78681 · Williamson County

Emergency services Birthing friendly

North Austin Medical Center

Acute Care Hospitals · Austin, TX

4/5 CMS rating

OwnershipProprietary

CMS Certification Number450809

Location12221 Mopac Expressway NorthAustin, TX 78758 · Travis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78749 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

$131.95 typical visit price

range $57.88 – $174.00

Typical copayment $32.98 (range $14.47 – $43.50)

Most-billed visit code 99204

Established Patient

$101.65 typical visit price

range $18.88 – $142.23

Typical copayment $25.41 (range $4.72 – $35.55)

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.

80.78/100

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

Scored as part of a group practice

Quality

89.18

Improvement Activities

Cost

41.68

Referred Medical Equipment & Supplies CMS DME claims 14

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

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers12 claims12 services$9.90 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers15 claims67 services$1.55 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

6 suppliers55 claims55 services$15.16 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

3 suppliers24 claims24 services$921.40 avg. paid by Medicare

High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each E0483

DME-Other DME · category DE000N

2 suppliers32 claims32 services$825.26 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier14 claims16 services$11.08 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 9

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

MITCHELL GUTIERREZ

Registered Nurse