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PAVANKUMAR PATEL MD
NPI 1407004708
Internal Medicine - Endocrinology, Diabetes & Metabolism in Palm Bay, FL

Active since August 29, 2008PECOS EnrolledAccepts Medicare Assignment
82.54/100
CMS Quality Rating
5200 BABCOCK ST NE STE 106A, PALM BAY, FL 32905(321) 373-7700(321) 256-5512 Get Directions Write a Review

NPPES record last updated: October 31, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 16, 2021, Jun 26, 2020, May 10, 2019 and 2 more (5 updates tracked since 2017).

About Pavankumar Patel Md NPPES

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

PAVANKUMAR PATEL MD (NPI 1407004708) is an individual endocrinology, diabetes & metabolism provider in Palm Bay, Florida, licensed in Florida (ME166782) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS, is affiliated with Holmes Regional Medical Center, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1407004708
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NamePAVANKUMAR PATELCredential: MD
Location Address5200 BABCOCK ST NE STE 106APalm Bay, FL 32905-4639
Mailing AddressPo Box 361095Melbourne, FL 32936-1095 · (321) 253-2900 · Fax (321) 435-0100
Phone(321) 373-7700
Fax(321) 256-5512
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateAugust 29, 2008
Last NPPES UpdateOctober 31, 20255 updates tracked since enumeration
NPPES CertifiedOctober 31, 2025
✔ NPI 1407004708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in FL · ME166782
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedInternal MedicineTaxonomy 207R00000X · License 01069508A (IN), MD449832 (PA)
Also ListedHospitalistTaxonomy 208M00000X · License MD449832 (PA)
5200 BABCOCK ST NE STE 106A, Palm Bay, FL 32905
Open in Google Maps ↗

Other Identifiers 1

Medicaid102882048PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Florida Health Care Plans 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

Pavankumar 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 ID7416135934
PECOS Enrollment IDI20140804000703, I20251023002504
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 Pavankumar Patel reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Medical Associates Of Brevard LLC
7.7 mi
Multi-Specialty
2200 W EAU GALLIE BLVD STE 200
Melbourne, FL 32935
  • Reassigned Medicare billing, Florida enrollment
  • 89 clinicians in this Medicare group
NPI 1861400103 (321) 253-2900
Pinnacle Health Medical Services
833 mi
Family Medicine
300 W KING ST
Littlestown, PA 17340
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,902 clinicians in this Medicare group
NPI 1669950440 (717) 359-9214
Pinnacle Health Hospitalist Services LLC
873 mi
Hospitalist
4300 LONDONDERRY RD
Harrisburg, PA 17109
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 322 clinicians in this Medicare group
NPI 1023458148 (717) 231-8772

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 4

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 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.
355 services261 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.
89 services83 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
54 services42 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.
49 services49 patients

Hospital Affiliations CMS Care Compare 3

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

Holmes Regional Medical Center

Acute Care Hospitals · Melbourne, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100019
Location1350 S Hickory StMelbourne, FL 32901 · Brevard County
Emergency services Birthing friendly

Palm Bay Hospital

Acute Care Hospitals · Palm Bay, FL
4/5 CMS rating
OwnershipProprietary
CMS Certification Number100316
Location1425 Malabar Rd, NEPalm Bay, FL 32907 · Brevard County
Emergency services

Upmc Pinnacle Hospitals

Acute Care Hospitals · Harrisburg, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390067
Location409 South Second StreetHarrisburg, PA 17104 · Dauphin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32905 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

82.54/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.62
Promoting Interoperability100
Improvement Activities40
Cost65.18

Referred Medical Equipment & Supplies CMS DME claims 9

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
7 suppliers44 claims569 services$18.29 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
7 suppliers43 claims1,490 services$2.29 avg. paid by Medicare
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238
DME-Medical/Surgical Supplies · category DA000N
3 suppliers13 claims13 services$172.08 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
30 suppliers71 claims322 services$5.74 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
17 suppliers31 claims63 services$0.99 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
3 suppliers36 claims36 services$307.98 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 Pavankumar Patel's NPI number?

The NPI number for Pavankumar Patel is 1407004708. It was assigned to this individual provider in the NPPES registry on August 29, 2008.

Where is Pavankumar Patel located?

Pavankumar Patel practices at 5200 Babcock St NE Ste 106A, Palm Bay, FL 32905. The listed phone number is (321) 373-7700.

What is Pavankumar Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Pavankumar Patel enrolled in Medicare?

Yes. Pavankumar 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 Pavankumar Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pavankumar Patel reassigns Medicare benefits to 3 organizations: Medical Associates Of Brevard LLC (Melbourne, FL), Pinnacle Health Medical Services (Littlestown, PA) and Pinnacle Health Hospitalist Services LLC (Harrisburg, PA). 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 Pavankumar Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pavankumar Patel accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Florida Health Care Plans and UnitedHealthcare list Pavankumar 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 Pavankumar Patel affiliated with any hospitals?

According to CMS data, Pavankumar Patel is affiliated with Holmes Regional Medical Center, Palm Bay Hospital and Upmc Pinnacle Hospitals.

When was this NPI record last updated?

The NPPES record for Pavankumar Patel was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.