NILAY PATEL MD
NPI 1356738108
Orthopaedic Surgery - Sports Medicine in Hiram, GA

Q: What is Nilay Patel's NPI number?

The NPI number for Nilay Patel is 1356738108. It was assigned to this individual provider in the NPPES registry on April 20, 2015.

Q: What is Nilay Patel's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Nilay Patel was last updated on November 14, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 20, 2015PECOS EnrolledAccepts Medicare Assignment

92.93/100

CMS Quality Rating

2518 JIMMY LEE SMITH PKWY, HIRAM, GA 30141(404) 321-9900 Get Directions Write a Review

NPPES record last updated: November 14, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 14, 2022, Aug 1, 2022 (2 updates tracked since 2022).

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About Nilay Patel Md NPPES

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

NILAY PATEL MD (NPI 1356738108) is an individual sports medicine provider in Hiram, Georgia, licensed in Georgia (92481) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and maintains a secondary practice location in Hiram.

NPPES Registry Identity

NPI1356738108

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameNILAY PATELCredential: MD

Location Address2518 JIMMY LEE SMITH PKWYHiram, GA 30141-2068

Mailing Address2518 Jimmy Lee Smith PkwyHiram, GA 30141-2068

Phone(404) 321-9900

Sole ProprietorNo

Medical School CMSAlbany Medical College Of Union UniversityGraduated 2015

Enumeration DateApril 20, 2015

Last NPPES UpdateNovember 14, 20222 updates tracked since enumeration

NPPES CertifiedNovember 14, 2022

✔ NPI 1356738108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in GA · 92481

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

2518 JIMMY LEE SMITH PKWY, Hiram, GA 30141

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Secondary Practice Location 1

Location 1148 Bill Carruth Pkwy Ste 120Hiram, GA 30141-3756 · Phone (943) 202-7010 · Fax (470) 986-7005

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

Nilay 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 ID7911279351

PECOS Enrollment IDI20220711001683

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 13

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.

291 services141 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

282 services91 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

193 services96 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.

151 services151 patients

Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose J7323

Hyaluronan or Euflexxa is a substance similar to a natural substance in your joints. It's injected into the joint space to treat pain from osteoarthritis, especially in the knee. It helps to lubricate the joint, reducing pain and improving mobility.

103 services25 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

101 services76 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

81 services55 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.

35 services35 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.

28 services26 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

27 services13 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.

25 services25 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

12 services11 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.

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.

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

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

Quality

80.38

Promoting Interoperability

100

Improvement Activities

Leave this field empty

Other Providers at the Same Location NPPES 20

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

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