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RACHNA PATEL M.D.
NPI 1386024859
Internal Medicine - Critical Care Medicine in Conyers, GA

Active since May 31, 2015PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1380 MILSTEAD AVE NE STE C, CONYERS, GA 30012(770) 918-2310 Get Directions Write a Review

NPPES record last updated: January 27, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 27, 2023, Jun 17, 2019 (2 updates tracked since 2019).

About Rachna Patel M.d. NPPES

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

RACHNA PATEL M.D. (NPI 1386024859) is an individual critical care medicine provider in Conyers, Georgia, licensed in Georgia (94422) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS, is affiliated with Piedmont Newton Hospital, and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1386024859
Entity TypeIndividualFemale
Primary Taxonomy207RC0200X
Provider Legal NameRACHNA PATELCredential: M.D.
Location Address1380 MILSTEAD AVE NE STE CConyers, GA 30012-3864
Mailing Address2450 W Hunting Park AvePhiladelphia, PA 19129-1302 · (215) 707-1622 · Fax (215) 707-0943
Phone(770) 918-2310
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 31, 2015
Last NPPES UpdateJanuary 27, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2023
✔ NPI 1386024859 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 GA · 94422
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 MD467301 (PA)
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 94422 (GA)
1380 MILSTEAD AVE NE STE C, Conyers, GA 30012
Open in Google Maps ↗

Secondary Practice Location 1

Location 1245 N 15th St Fl 6Philadelphia, PA 19102-1101 · Phone (215) 762-7916 · Fax (215) 762-7765

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

Rachna 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 ID5698027118
PECOS Enrollment IDI20230310002557
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.

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.
159 services68 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.
125 services78 patients
Sleep study including heart rate, breathing, and sleep time 95800
A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.
74 services72 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.
61 services40 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.
54 services40 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.
49 services36 patients

Hospital Affiliations CMS Care Compare 3

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

Piedmont Newton Hospital

Acute Care Hospitals · Covington, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110018
Location5126 Hospital Drive NECovington, GA 30014 · Newton County
Emergency services Birthing friendly

Piedmont Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110083
Location1968 Peachtree Rd NWAtlanta, GA 30309 · Fulton County
Emergency services Birthing friendly

Piedmont Rockdale Hospital

Acute Care Hospitals · Conyers, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110091
Location1412 Milstead Avenue, NEConyers, GA 30012 · Rockdale County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30012 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

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

Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$29.12 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 2

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

DR. CHRISTIN-LAUREN TANKSLEY M.D.
Internal Medicine (Pulmonary Disease)
1380 MILSTEAD AVE NE STE C
CONYERS, GA 30012
Rockdale County (770) 918-2310
PT SOLUTIONS OF ACWORTH LLC
Physical Therapist
1380 MILSTEAD AVE NE STE C
CONYERS, GA 30012
Rockdale County (470) 474-1490

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 Rachna Patel's NPI number?

The NPI number for Rachna Patel is 1386024859. It was assigned to this individual provider in the NPPES registry on May 31, 2015.

Where is Rachna Patel located?

Rachna Patel practices at 1380 Milstead Ave NE Ste C, Conyers, GA 30012. The listed phone number is (770) 918-2310.

What is Rachna Patel's specialty?

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

Is Rachna Patel enrolled in Medicare?

Yes. Rachna 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 Rachna Patel accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Rachna 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 Rachna Patel affiliated with any hospitals?

According to CMS data, Rachna Patel is affiliated with Piedmont Newton Hospital, Piedmont Hospital and Piedmont Rockdale Hospital.

When was this NPI record last updated?

The NPPES record for Rachna Patel was last updated on January 27, 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.