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HETAL V PATEL M.D.
NPI 1386878239
Family Medicine in York, PA

Active since May 06, 2009PECOS EnrolledAccepts Medicare Assignment
116 S GEORGE ST, YORK, PA 17401(717) 845-8617(717) 854-6645 Get Directions Write a Review

NPPES record last updated: April 24, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 24, 2018, Nov 23, 2016 (2 updates tracked since 2016).

About Hetal V Patel M.d. NPPES

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

HETAL V PATEL M.D. (NPI 1386878239) is an individual family medicine provider in York, Pennsylvania, licensed in Pennsylvania (MD452228) and active in the NPI registry since May 2009. She is enrolled in Medicare PECOS, is affiliated with Wellspan York Hospital, and is a graduate of University Of Maryland School Of Medicine (2009).

NPPES Registry Identity

NPI1386878239
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameHETAL V PATELCredential: M.D.
Location Address116 S GEORGE STYork, PA 17401-1474
Mailing Address116 S George StYork, PA 17401-1474 · (717) 801-4821 · Fax (717) 854-0377
Phone(717) 845-8617
Fax(717) 854-6645
Sole ProprietorNo
Medical School CMSUniversity Of Maryland School Of MedicineGraduated 2009
Enumeration DateMay 6, 2009
Last NPPES UpdateApril 24, 20182 updates tracked since enumeration
✔ NPI 1386878239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · MD452228
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPreventive Medicine · Public Health & General Preventive MedicineTaxonomy 2083P0901X · License MD452228 (PA)
116 S GEORGE ST, York, PA 17401
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Other Identifiers 1

Medicaid102962766PA

Accepted Insurance

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

Hetal V 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 ID8527211192
PECOS Enrollment IDI20130109000651, I20161228001510
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.

Hospital Affiliations CMS Care Compare

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

Wellspan York Hospital

Acute Care Hospitals · York, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390046
Location1001 South George StreetYork, PA 17403 · York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17401 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
54%389 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
43%722 patients3/55-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
29%369 patients2/55-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.
99%2,801 patients5/55-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…
63%304 patients3/55-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.
100%1,281 patients5/55-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.
95%3,426 patients4/55-star benchmark: 97%
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…
100%3,426 patients5/55-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…
11%3,426 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.
22%3,426 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.

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.

MS. NICOLE MARIE CAMPANELLA CNM
Nurse Practitioner (Family)
116 S GEORGE ST
YORK, PA 17401
York County (717) 845-8617
JESSICA GLOVER
Community Health Worker
116 S GEORGE ST
YORK, PA 17401
York County (717) 845-8617
ASCELINE SO GO M.D.
Family Medicine
116 S GEORGE ST, SUITE 200
YORK, PA 17401
York County (717) 845-8617
DR. MARIA LINA THARP FLETCHER D.M.D
Dentist
116 S GEORGE ST, SUITE 301
YORK, PA 17401
York County (717) 801-4821
WENDY GRUBBS
Nurse Practitioner (Family)
116 S GEORGE ST, SUITE 301
YORK, PA 17401
York County (717) 845-8617
TANYA MARIE BARR
Nurse Practitioner (Family)
116 S GEORGE ST
YORK, PA 17401
York County (717) 845-8617
MAHGOL MEHRANPOUR DMD
Dentist (General Practice)
116 S GEORGE ST
YORK, PA 17401
York County (717) 845-8617
JESSICA L BOORE RDH
Dental Hygienist
116 S GEORGE ST
YORK, PA 17401
York County (717) 845-8617

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 Hetal Patel's NPI number?

The NPI number for Hetal Patel is 1386878239. It was assigned to this individual provider in the NPPES registry on May 6, 2009.

Where is Hetal Patel located?

Hetal Patel practices at 116 S George St, York, PA 17401. The listed phone number is (717) 845-8617.

What is Hetal Patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Hetal Patel enrolled in Medicare?

Yes. Hetal 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 Hetal Patel accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Hetal 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 Hetal Patel affiliated with any hospitals?

According to CMS data, Hetal Patel is affiliated with Wellspan York Hospital.

When was this NPI record last updated?

The NPPES record for Hetal Patel was last updated on April 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.