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MAULIK PANCHAL M.D.
NPI 1396172748
Hospitalist in West Reading, PA

Active since October 01, 2013PECOS EnrolledAccepts Medicare Assignment
94.07/100
CMS Quality Rating
420 S 5TH AVE, WEST READING, PA 19611(484) 628-5455 Get Directions Write a Review

NPPES record last updated: June 27, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 23, 2018, Mar 28, 2017 (2 updates tracked since 2017).

About Maulik Panchal M.d. NPPES

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

MAULIK PANCHAL M.D. (NPI 1396172748) is an individual hospitalist provider in West Reading, Pennsylvania, licensed in Virginia (0101266168) and active in the NPI registry since October 2013. He is enrolled in Medicare PECOS, is affiliated with Riverside Regional Medical Center, and maintains a secondary practice location in Reading.

NPPES Registry Identity

NPI1396172748
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameMAULIK PANCHALCredential: M.D.
Location Address420 S 5TH AVEWest Reading, PA 19611-2143
Mailing Address856 J Clyde Morris Blvd, Ste ANewport News, VA 23601-1318 · (757) 316-5800 · Fax (757) 534-5190
Phone(484) 628-5455
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateOctober 1, 2013
Last NPPES UpdateJune 27, 20192 updates tracked since enumeration
✔ NPI 1396172748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
Licenses✔ Licensed in VA · 0101266168✔ Licensed in PA · MD456908
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
420 S 5TH AVE, West Reading, PA 19611
Open in Google Maps ↗

Secondary Practice Location 1

Location 16th ave and Spurce streetReading, PA 19611 · Phone (484) 628-5455

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

Maulik Panchal 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 ID1658662929
PECOS Enrollment IDI20190806000254
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

2

Medicare enrollment records show Maulik Panchal reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tower Health Medical Group
Same address
Trauma Surgery
420 S 5TH AVE
West Reading, PA 19611
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,473 clinicians in this Medicare group
NPI 1063589273 (484) 628-4879
Riverside Physician Services Inc
203 mi
Hospice and Palliative Medicine
7580 HOSPITAL DR STE 201
Gloucester, VA 23061
  • Reassigned Medicare billing, Virginia enrollment
  • 1,097 clinicians in this Medicare group
NPI 1679023428 (804) 695-8592

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 7

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 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.
393 services145 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.
109 services64 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
106 services105 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.
68 services67 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
53 services33 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

Riverside Regional Medical Center

Acute Care Hospitals · Newport News, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490052
Location500 J Clyde Morris BlvdNewport News, VA 23601 · Newport News City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19611 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
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.

94.07/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality90.65
Promoting Interoperability95.83
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers37 claims37 services$3.87 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers26 claims26 services$60.57 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
2 suppliers11 claims11 services$13.45 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 20

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

TOLUWANIMI OGBONMIDE
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
URVASHI SARKAR
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
MADISON HECK
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
NEIL HOFFMAN M.D.
Pathology (Forensic Pathology)
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8615
MS. LANE ROSCOE PA- C
Physician Assistant
420 S 5TH AVE
WEST READING, PA 19611
Berks County (610) 568-3637
ALICE LEE DO
Surgery
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-4879
KYLE ROMPALA
Nurse Practitioner (Family)
420 S 5TH AVE
READING, PA 19611
Berks County (267) 280-7615
MATTHEW CRYER
Emergency Medicine
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-1324

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 Maulik Panchal's NPI number?

The NPI number for Maulik Panchal is 1396172748. It was assigned to this individual provider in the NPPES registry on October 1, 2013.

Where is Maulik Panchal located?

Maulik Panchal practices at 420 S 5th Ave, West Reading, PA 19611. The listed phone number is (484) 628-5455.

What is Maulik Panchal's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Maulik Panchal enrolled in Medicare?

Yes. Maulik Panchal 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 Maulik Panchal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Maulik Panchal reassigns Medicare benefits to 2 organizations: Tower Health Medical Group (West Reading, PA) and Riverside Physician Services Inc (Gloucester, VA). 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 Maulik Panchal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Maulik Panchal affiliated with any hospitals?

According to CMS data, Maulik Panchal is affiliated with Riverside Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Maulik Panchal was last updated on June 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.