DR. VIRAL P PATEL MD
NPI 1417169541
Family Medicine in Middletown, PA

Active since May 03, 2007PECOS EnrolledAccepts Medicare Assignment
82.54/100
CMS Quality Rating
1025 W HARRISBURG PIKE, MIDDLETOWN, PA 17057(717) 944-0491(717) 944-1436 Get Directions Write a Review

NPPES record last updated: January 16, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 16, 2021, Jun 26, 2020, Sep 10, 2018 and 2 more (5 updates tracked since 2016).

About Dr. Viral P Patel Md NPPES

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

DR. VIRAL P PATEL MD (NPI 1417169541) is an individual family medicine provider in Middletown, Pennsylvania, licensed in Pennsylvania (MD443128) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Upmc Pinnacle Hospitals, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1417169541
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. VIRAL P PATELCredential: MD
Location Address1025 W HARRISBURG PIKEMiddletown, PA 17057-4848
Mailing Address1025 W Harrisburg PikeMiddletown, PA 17057-4848 · (717) 944-0491 · Fax (717) 944-1436
Fax(717) 944-1436
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateMay 3, 2007
Last NPPES UpdateJanuary 16, 20215 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2021
NPI 1417169541 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 · MD443128
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 ListedSurgeryTaxonomy 208600000X · License MT190308 (PA)
1025 W HARRISBURG PIKE, Middletown, PA 17057

Other Identifiers 1

Medicaid102612365PA

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

Dr. Viral P 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 ID7113196254
PECOS Enrollment IDI20110808000272
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 7

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.
585 services252 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
190 services190 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
52 services52 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
40 services38 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
29 services27 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
22 services19 patients

Hospital Affiliations CMS Care Compare 2

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

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

Upmc Memorial

Acute Care Hospitals · York, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390101
Location1701 Innovation DriveYork, PA 17408 · York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17057 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.

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 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers22 claims61 services$6.74 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers16 claims29 services$1.20 avg. paid by Medicare
Neuromuscular stimulator, electronic shock unit E0745
DME-Other DME · category DE000N
1 supplier11 claims12 services$62.11 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
2 suppliers17 claims17 services$84.45 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 11

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

Family Medicine
1025 W HARRISBURG PIKE
MIDDLETOWN, PA 17057
Family Medicine
1025 W HARRISBURG PIKE
MIDDLETOWN, PA 17057
Nurse Practitioner (Family)
1025 W HARRISBURG PIKE
MIDDLETOWN, PA 17057
Nurse Practitioner
1025 W HARRISBURG PIKE
MIDDLETOWN, PA 17057
Family Medicine
1025 W HARRISBURG PIKE
MIDDLETOWN, PA 17057
Nurse Practitioner
1025 W HARRISBURG PIKE
MIDDLETOWN, PA 17057
Nurse Practitioner (Family)
1025 W HARRISBURG PIKE
MIDDLETOWN, PA 17057
Family Medicine
1025 W HARRISBURG PIKE
MIDDLETOWN, PA 17057

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417169541, enumerated as an "individual" on May 03, 2007.

The provider is located at 1025 W HARRISBURG PIKE MIDDLETOWN, PA 17057 and the phone number is (717) 944-0491.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Viral Patel is affiliated with: UPMC PINNACLE HOSPITALS and UPMC MEMORIAL.