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PRAGNESH PATEL MD
NPI 1386682441
Internal Medicine in Detroit, MI

Active since June 02, 2006PECOS EnrolledAccepts Medicare Assignment
4201 ST ANTOINE, STE 5B, DRH ROSA PARKS WELLNESS INSTITUTE FOR SR HEALTH, DETROIT, MI 48201(313) 745-1741(313) 745-8165 Get Directions Write a Review

NPPES record last updated: January 21, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Pragnesh Patel Md NPPES

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

PRAGNESH PATEL MD (NPI 1386682441) is an individual internal medicine provider in Detroit, Michigan, licensed in Michigan (4301070713) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with St Joe Mercy Hospital System Livonia, and is a graduate of Wayne State University School Of Medicine (1997).

NPPES Registry Identity

NPI1386682441
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePRAGNESH PATELCredential: MD
Location Address4201 ST ANTOINE, STE 5B, DRH ROSA PARKS WELLNESS INSTITUTE FOR SR HEALTHDetroit, MI 48201-2153
Mailing Address1560 E Maple Rd, Suite 400-credentialingTroy, MI 48083-1138 · (313) 745-1741 · Fax (313) 745-8165
Phone(313) 745-1741
Fax(313) 745-8165
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 1997
Enumeration DateJune 2, 2006
Last NPPES UpdateJanuary 21, 2021
NPPES CertifiedJanuary 21, 2021
✔ NPI 1386682441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301070713
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Geriatric MedicineTaxonomy 207RG0300X · License 4301070713 (MI)
Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X · License 4301070713 (MI)
4201 ST ANTOINE, STE 5B, Detroit, MI 48201
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Pragnesh 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 ID4385673714
PECOS Enrollment IDI20050805000781
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Pragnesh Patel reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Physician Group
Same address
Advanced Practice Midwife
4201 SAINT ANTOINE ST, SUITE 4E&F
Detroit, MI 48201
  • Reassigned Medicare billing, Michigan enrollment
  • 731 clinicians in this Medicare group
NPI 1437198231 (313) 745-4380
Dr Pragnesh Patel Plc
13 mi
Geriatric Medicine
33811 KING RICHARD DR
Sterling Heights, MI 48310
  • Reassigned Medicare billing, Michigan enrollment
  • 3 clinicians in this Medicare group
NPI 1164068227 (586) 871-7949
Bn Nandish MD PC Inc
24 mi
Internal Medicine
45438 IRVINE DR
Novi, MI 48374
  • Reassigned Medicare billing, Michigan enrollment
  • 5 clinicians in this Medicare group
NPI 1710912605 (248) 449-4032

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
277 services233 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
222 services212 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
191 services49 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.
110 services62 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
52 services48 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.
40 services30 patients

Hospital Affiliations CMS Care Compare 3

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

St Joe Mercy Hospital System Livonia

Acute Care Hospitals · Livonia, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230002
Location36475 Five Mile RoadLivonia, MI 48154 · Wayne County
Emergency services Birthing friendly

Harper University Hospital

Acute Care Hospitals · Detroit, MI
1/5 CMS rating
OwnershipProprietary
CMS Certification Number230104
Location3990 John R StreetDetroit, MI 48201 · Wayne County
Emergency services Birthing friendly

Detroit Receiving Hospital

Acute Care Hospitals · Detroit, MI
1/5 CMS rating
OwnershipProprietary
CMS Certification Number230273
Location4201 St Antoine St - 2CDetroit, MI 48201 · Wayne County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48201 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
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

Referred Medical Equipment & Supplies CMS DME claims 10

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

Ostomy skin barrier, powder, per oz A4371
DME-Orthotic Devices · category DF010N
1 supplier13 claims13 services$3.52 avg. paid by Medicare
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
1 supplier13 claims312 services$2.50 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each A4414
DME-Orthotic Devices · category DF010N
1 supplier13 claims260 services$4.38 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063
DME-Orthotic Devices · category DF010N
1 supplier13 claims260 services$2.55 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
1 supplier13 claims550 services$0.23 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
7 suppliers14 claims14 services$60.37 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Pragnesh Patel's NPI number?

The NPI number for Pragnesh Patel is 1386682441. It was assigned to this individual provider in the NPPES registry on June 2, 2006.

Where is Pragnesh Patel located?

Pragnesh Patel practices at 4201 St Antoine, Ste 5B Drh Rosa Parks Wellness Institute For Sr Health, Detroit, MI 48201. The listed phone number is (313) 745-1741.

What is Pragnesh Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pragnesh Patel enrolled in Medicare?

Yes. Pragnesh 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.

Which organizations bill Medicare for Pragnesh Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pragnesh Patel reassigns Medicare benefits to 3 organizations: University Physician Group (Detroit, MI), Dr Pragnesh Patel Plc (Sterling Heights, MI) and Bn Nandish MD PC Inc (Novi, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pragnesh Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pragnesh Patel accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Pragnesh 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 Pragnesh Patel affiliated with any hospitals?

According to CMS data, Pragnesh Patel is affiliated with St Joe Mercy Hospital System Livonia, Harper University Hospital and Detroit Receiving Hospital.

When was this NPI record last updated?

The NPPES record for Pragnesh Patel was last updated on January 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.