SUNNY PATEL MD
NPI 1336583467
Internal Medicine - Rheumatology in Red Oak, TX

Active since April 19, 2013PECOS EnrolledAccepts Medicare Assignment
75.95/100
CMS Quality Rating
106 PLAZA DR, RED OAK, TX 75154(469) 552-6630 Get Directions Write a Review

NPPES record last updated: January 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 24, 2023, Sep 14, 2018, Jul 24, 2018 (3 updates tracked since 2018).

About Sunny Patel Md NPPES

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

SUNNY PATEL MD (NPI 1336583467) is an individual rheumatology provider in Red Oak, Texas, licensed in Texas (R5621) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Baylor Scott & White Medical Center- Waxahachie, and maintains a secondary practice location in Shreveport.

NPPES Registry Identity

NPI1336583467
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameSUNNY PATELCredential: MD
Location Address106 PLAZA DRRed Oak, TX 75154
Mailing Address106 Plaza DrRed Oak, TX 75154-3981 · (469) 552-6630 · Fax (469) 552-6930
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateApril 19, 2013
Last NPPES UpdateJanuary 24, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 24, 2023
NPI 1336583467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
Licenses Licensed in TX · R5621 Licensed in LA · MD.303245
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
106 PLAZA DR, Red Oak, TX 75154

Secondary Practice Location 1

Location 11501 Kings Hwy, RheumatologyShreveport, LA 71103-4228 · Phone (318) 813-2500 · Fax (318) 813-2525

Accepted 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

Sunny 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 ID6406106798
PECOS Enrollment IDI20180907000461
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 14

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.

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0717
Certolizumab pegol is a medication injected under a doctor's supervision. It's used to treat certain inflammatory conditions like rheumatoid arthritis. The injection helps reduce symptoms like pain and swelling. Note that this drug isn't for self-administration.
88,000 services44 patients
Injection, golimumab, 1 mg, for intravenous use J1602
Golimumab is a medication given through an IV (a small tube in your vein). It helps to reduce inflammation and pain by blocking a protein in your body that causes inflammation. It's often used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
16,050 services29 patients
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0129
Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.
11,525 services32 patients
Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
2,340 services36 patients
Injection, infliximab, excludes biosimilar, 10 mg J1745
Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.
2,330 services17 patients
Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle 96401
This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.
502 services84 patients

Hospital Affiliations CMS Care Compare

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

Baylor Scott & White Medical Center- Waxahachie

Acute Care Hospitals · Waxahachie, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450372
Location2400 N Interstate Highway 35EWaxahachie, TX 75165 · Ellis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75154 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

75.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.91
Improvement Activities40
Cost53.28

Reported Quality Measures

e-Prescribing
99%1,654 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
98%864 patients4/55-star benchmark: 100%
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.

Other Providers at the Same Location NPPES 5

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

Nurse Practitioner
106 PLAZA DR
RED OAK, TX 75154
Pain Medicine (Pain Medicine)
106 PLAZA DR
OVILLA, TX 75154
Anesthesiology (Pain Medicine)
106 PLAZA DR
RED OAK, TX 75154
Clinic/Center (Urgent Care)
106 PLAZA DR
RED OAK, TX 75154
Dentist (General Practice)
106 PLAZA DR
RED OAK, TX 75154

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 Sunny Patel's NPI number?

The NPI number for Sunny Patel is 1336583467. It was assigned to this individual provider in the NPPES registry on April 19, 2013.

Where is Sunny Patel located?

Sunny Patel practices at 106 Plaza Dr, Red Oak, TX 75154. The listed phone number is (469) 552-6630.

What is Sunny Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Sunny Patel enrolled in Medicare?

Yes. Sunny 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 Sunny Patel accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Sunny 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 Sunny Patel affiliated with any hospitals?

According to CMS data, Sunny Patel is affiliated with Baylor Scott & White Medical Center- Waxahachie.

When was this NPI record last updated?

The NPPES record for Sunny Patel was last updated on January 24, 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.