VIREL R PRAJAPATI PA-C
NPI 1417284811
Physician Assistant in Rahway, NJ
NPI Status: Active since November 06, 2009
- Individual
- Male
- Years of Experience 15
- Physician Assistant
- PECOS Enrolled
- Accepts Medicare Approved Payment
About VIREL PRAJAPATI
Virel Prajapati is a primary care provider established in Rahway, New Jersey and his medical specialization is Physician Assistant with more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1417284811 assigned on November 2009. The practitioner's primary taxonomy code is 363A00000X with license number 25MP00228300 (NJ). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1417284811
- Provider Name
- VIREL R PRAJAPATI PA-C
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 865 STONE ST RAHWAY, NJ 07065
- Location Phone
- (732) 381-4949
- Mailing Address
- 1302 ROBERTS WAY VOORHEES, NJ 08043
- Mailing Phone
- (609) 217-1847
- Medical School Name
- OTHER
- Graduation Year
- 2009
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-06-2009
- Last Update Date
- 11-06-2009
- Code Navigator
A primary care provider (PCP) like Virel Prajapati sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Virel Prajapati is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
The typical physician office visit costs for Medicare beneficiaries in this area are: $25.35 for a new patient copayment and $20.64 for an established patient copayment.
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 25MP00228300
- License State
- NJ
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Ambetter from Buckeye Health Plan
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Clear Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
Ambetter Health of Delaware
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Everyday Silver - EPO
- Everyday Silver + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Premier Bronze HSA - EPO
- Premier Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
PECOS Enrollment and Medicare Participation Status
Virel Prajapati is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1951443282
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20130918000502
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 07065 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $101.4
- Minimum New Patient Price $66.45
- Maximum New Patient Price $198.48
- Average New Patient Copayment $25.35
- Minimum New Patient Copayment $16.61
- Maximum New Patient Copayment $49.62
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $82.58
- Minimum Established Patient Price $21.27
- Maximum Established Patient Price $162.58
- Average Established Patient Copayment $20.64
- Minimum Established Patient Copayment $5.31
- Maximum Established Patient Copayment $40.64
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 1 | 7 | 2 | 8 | 4 | 8 | 1 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 2 | 7 | 4 | 8 | 8 | 8 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 2 + 7 + 4 + 8 + 8 + 8 + 2 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1417284811 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1215921051 | ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL @ RAHWAY Organization | Skilled Nursing Facility | 865 STONE ST RAHWAY, NJ 07065 (732) 499-6084 |
| 1992752331 | DR. SCHUBERT PEROTTE MD Individual | Emergency Medicine | 865 STONE ST RAHWAY, NJ 07065 (732) 381-4200 |
| 1932134285 | RAYSHMA ALI Individual | Emergency Medicine (Emergency Medical Services) | 865 STONE ST RAHWAY, NJ 07065 (732) 680-7911 |
| 1700985546 | RAHWAY ANESTHESIOLOGISTS, PA Organization | Specialist | 865 STONE ST RAHWAY, NJ 07065 (732) 381-6303 |
| 1487753257 | FRANCIS B LIGHT MD Individual | Specialist | 865 STONE ST RAHWAY, NJ 07065 (732) 381-6303 |
| 1508965237 | DOMINICK T LUCIANO MD Individual | Anesthesiology | 865 STONE ST RAHWAY, NJ 07065 (732) 381-6303 |
| 1265504062 | MICHELLE YE MD Individual | Specialist | 865 STONE ST RAHWAY, NJ 07065 (732) 499-6139 |
| 1558400093 | GEORGE NEUMANN CRNA Individual | Specialist | 865 STONE ST RAHWAY, NJ 07065 (732) 381-6303 |
| 1881733327 | ROBERTA J FRIMPTER CRNA Individual | Nurse Anesthetist, Certified Registered | 865 STONE ST RAHWAY, NJ 07065 (732) 381-6303 |
| 1558486092 | DR. CONCEPCION DANCEL MD Individual | Emergency Medicine | 865 STONE ST RAHWAY, NJ 07065 (732) 381-4200 |
| 1124244009 | DR. SCOTT MERLIN M.D. Individual | Specialist | 865 STONE ST DEPARTMENT OF PATHOLOGY RAHWAY, NJ 07065 (732) 499-6139 |
| 1194961235 | HECTOR J SANCHEZ M D P C Organization | Surgery | 865 STONE ST RAHWAY, NJ 07065 (732) 381-4949 |
| 1265661425 | LAURA TAYLOR JOHNSON PAC Individual | Physician Assistant | 865 STONE ST RAHWAY, NJ 07065 (732) 680-7911 |
| 1326334327 | MS. JANETTA MORRIS R.T. Individual | Radiologic Technologist (Computed Tomography) | 865 STONE ST RAHWAY, NJ 07065 (732) 499-6119 |
| 1366727349 | NICOLE DENNY MA CCC/SLP Individual | Speech-Language Pathologist | 865 STONE ST RAHWAY, NJ 07065 (201) 739-5951 |
| 1316235443 | ASHLEY PARLAVECHIO PA-C Individual | Physician Assistant | 865 STONE ST RAHWAY, NJ 07065 (732) 381-4200 |
| 1376642132 | KYOUNG J SON MD Individual | Specialist | 865 STONE ST RAHWAY, NJ 07065 (732) 381-6303 |
| 1497817985 | DR. LARRY PAUL KAPLAN M.D. Individual | Radiology (Diagnostic Radiology) | 865 STONE ST RAHWAY, NJ 07065 (952) 595-1100 |
| 1982653564 | EASTERN EMERGENCY PHYSICIANS LLC Organization | Emergency Medicine | 865 STONE ST RAHWAY, NJ 07065 (732) 381-4200 |
| 1376732578 | BELSIS RODRIGUEZ PA-C Individual | Physician Assistant | 865 STONE ST RAHWAY, NJ 07065 (732) 449-6100 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417284811, enumerated in the NPI registry as an "individual" on November 06, 2009
The provider is located at 865 Stone St Rahway, Nj 07065 and the phone number is (732) 381-4949
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider has more than 15 years of experience.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan and Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $101.4 with an average copayment of $25.35 for new patient appointments. Established patients should expect a typical charge of $82.58 and an average copayment of 20.64. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on November 06, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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