DR. SANJAY KUMAR PATEL M.D.
NPI 1326001603
Internal Medicine - Cardiovascular Disease in Hickory, NC

Q: What is Sanjay Patel's NPI number?

The NPI number for Sanjay Patel is 1326001603. It was assigned to this individual provider in the NPPES registry on April 8, 2006.

Q: What is Sanjay Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Sanjay Patel was last updated on December 4, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 08, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

1771 TATE BLVD SE, SUITE 201, HICKORY, NC 28602(828) 324-4804(828) 324-7256 Get Directions Write a Review

NPPES record last updated: December 4, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Sanjay Kumar Patel M.d. NPPES

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

DR. SANJAY KUMAR PATEL M.D. (NPI 1326001603) is an individual cardiovascular disease provider in Hickory, North Carolina, licensed in North Carolina (200100759) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Rutherford Regional Medical Center, and is a graduate of Indiana University School Of Medicine (1994).

NPPES Registry Identity

NPI1326001603

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. SANJAY KUMAR PATELCredential: M.D.

Location Address1771 TATE BLVD SE, SUITE 201Hickory, NC 28602-4249

Mailing Address1771 Tate Blvd Se, Suite 201Hickory, NC 28602-4249 · (828) 324-4804 · Fax (828) 324-7256

Phone(828) 324-4804

Fax(828) 324-7256

Sole ProprietorNo

Medical School CMSIndiana University School Of MedicineGraduated 1994

Enumeration DateApril 8, 2006

Last NPPES UpdateDecember 4, 2013

✔ NPI 1326001603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in NC · 200100759

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1771 TATE BLVD SE, Hickory, NC 28602

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Other Identifiers 4

Medicaid89129G9NC

Other129G9NC · Bcbs Of Nc Provider Id#

Medicare UPINH23104NC

Medicare PIN2289339NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee 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. Sanjay Kumar 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 ID4688715725

PECOS Enrollment IDI20100111000744

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 27

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.

573 services440 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

231 services170 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

213 services211 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

164 services163 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

151 services150 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.

134 services97 patients

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

123 services58 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

81 services81 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

81 services81 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.

79 services77 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

78 services78 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.

71 services71 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

58 services58 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.

57 services57 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

56 services56 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.

50 services39 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

41 services41 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

33 services33 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.

33 services33 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

26 services26 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

24 services24 patients

Heart rhythm recording of continous external ekg over 8-15 days 93246

A heart rhythm recording is a non-invasive procedure where a small device, attached externally, monitors your heart's electrical activity for 8-15 days. It helps detect irregular heart rhythms, assess heart rate, and guide treatment decisions. It's safe, painless, and can be done during normal daily activities.

21 services21 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

19 services18 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

16 services16 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel 92978

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

15 services15 patients

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days 93242

This procedure involves wearing a device, an external EKG, for up to 7 days to continuously monitor your heart rhythm. It helps detect irregularities that may not occur during a standard EKG. The device is non-invasive and safe.

15 services15 patients

Ultrasound of heart, follow-up 93308

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Rutherford Regional Medical Center

Acute Care Hospitals · Rutherfordton, NC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number340013

Location288 South Ridgecrest AveRutherfordton, NC 28139 · Rutherford County

Emergency services Birthing friendly

Caldwell Memorial Hospital

Acute Care Hospitals · Lenoir, NC

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number340041

Location321 Mulberry St SWLenoir, NC 28645 · Caldwell County

Emergency services

Frye Regional Medical Center

Acute Care Hospitals · Hickory, NC

1/5 CMS rating

OwnershipProprietary

CMS Certification Number340116

Location420 N Center StHickory, NC 28601 · Catawba County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28602 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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.

75/100

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

Scored through an Alternative Payment Model

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

9%338 patients1/55-star benchmark: 92%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

3%913 patients1/55-star benchmark: 85%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

5%342 patients1/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

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.

100%2,407 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

97%2,825 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

25%122 patients2/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

99%233 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

19%1,838 patients1/55-star benchmark: 97%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

8%1,085 patients1/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

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…

22%1,582 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

1%1,549 patients1/55-star benchmark: 96%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 100% · 613 patients

Patients tobacco: 12% · 89 patients

88%613 patients4/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

48%1,838 patients2/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

4%1,838 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

17%1,838 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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Other Providers at the Same Location NPPES 16

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

CATAWBA VALLEY INTERNAL MEDICINE PA

Internal Medicine

1771 TATE BLVD SE, SUITE 103
HICKORY, NC 28602

Catawba County (828) 322-1128

UNIFOUR SURGICAL ASSOICATES, PA

Surgery

1771 TATE BLVD SE, SUITE 101
HICKORY, NC 28602

Catawba County (828) 322-9105

HICKORY CARDIOLOGY ASSOCIATES PLLC

Internal Medicine (Cardiovascular Disease)

1771 TATE BLVD SE, SUITE 201
HICKORY, NC 28602

Catawba County (828) 324-4804

CATAWBA VALLEY INTERNAL MEDICINE

Psychiatry & Neurology (Psychiatry)

1771 TATE BLVD SE, STE 103
HICKORY, NC 28602

Catawba County (828) 322-1128

DR. THOMAS MICHAEL WILEY M.D.

Internal Medicine (Clinical Cardiac Electrophysiology)

1771 TATE BLVD SE, SUITE 201
HICKORY, NC 28602

Catawba County (828) 324-4804

PROFESSIONAL SLEEP DIAGNOSTICS

Clinic/Center (Sleep Disorder Diagnostic)

1771 TATE BLVD SE, SUITE #102
HICKORY, NC 28602

Catawba County (828) 485-2955

DLP CARDIOLOGY PHYSICIANS LLC

Internal Medicine (Cardiovascular Disease)

1771 TATE BLVD SE, STE 201
HICKORY, NC 28602

Catawba County (615) 920-7000

MR. DOUGLAS PARKER MILLER MD

Internal Medicine

1771 TATE BLVD SE, STE 103
HICKORY, NC 28602

Catawba County (828) 322-1128

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 Sanjay Patel's NPI number?

The NPI number for Sanjay Patel is 1326001603. It was assigned to this individual provider in the NPPES registry on April 8, 2006.

Where is Sanjay Patel located?

Sanjay Patel practices at 1771 Tate Blvd SE Suite 201, Hickory, NC 28602. The listed phone number is (828) 324-4804.

What is Sanjay Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Sanjay Patel enrolled in Medicare?

Yes. Sanjay 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 Sanjay Patel accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC and 1 other insurer list Sanjay 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 Sanjay Patel affiliated with any hospitals?

According to CMS data, Sanjay Patel is affiliated with Rutherford Regional Medical Center, Caldwell Memorial Hospital and Frye Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Sanjay Patel was last updated on December 4, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.