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DR. KAVAN GIRISHBHAI PATEL M.D.
NPI 1437541406
Internal Medicine - Gastroenterology in Toms River, NJ

Active since February 26, 2015PECOS Enrolled
425 LAKEHURST RD, TOMS RIVER, NJ 08755(732) 281-1590 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 12, 2025, Sep 23, 2024, Jul 1, 2020 and 1 more (4 updates tracked since 2019).

About Dr. Kavan Girishbhai Patel M.d. NPPES

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

DR. KAVAN GIRISHBHAI PATEL M.D. (NPI 1437541406) is an individual gastroenterology provider in Toms River, New Jersey, licensed in New Jersey (MA10103400) and active in the NPI registry since February 2015. He is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1437541406
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. KAVAN GIRISHBHAI PATELCredential: M.D.
Location Address425 LAKEHURST RDToms River, NJ 08755
Mailing Address425 Lakehurst RdToms River, NJ 08755-7378 · (732) 281-1590
Phone(732) 281-1590
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateFebruary 26, 2015
Last NPPES UpdateApril 21, 20254 updates tracked since enumeration
NPPES CertifiedApril 21, 2025
✔ NPI 1437541406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in NJ · MA10103400✔ Licensed in IA · MD-49075✔ Licensed in IL · 036153355
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
425 LAKEHURST RD, Toms River, NJ 08755
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Secondary Practice Locations 3

Location 1425 Lakehurst RdToms River, NJ 08755 · Phone (732) 281-1590
Location 2404 Lincoln DrHerrin, IL 62948-3789 · Phone (618) 993-0056 · Fax (618) 993-0752
Location 31015 S Hackett RdWaterloo, IA 50701-3543 · Phone (319) 234-5990

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Molina Healthcare, Quartz.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kavan Girishbhai Patel M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2769737337
PECOS Enrollment IDI20200818001324, I20211104001561
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 10

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.

Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
128 services120 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
95 services88 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
85 services83 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
76 services71 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.
36 services28 patients
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.
32 services19 patients

Hospital Affiliations CMS Care Compare 5

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

Herrin Hospital

Acute Care Hospitals · Herrin, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140011
Location201 S 14th StHerrin, IL 62948 · Williamson County
Emergency services

Trinity Regional Medical Center

Acute Care Hospitals · Fort Dodge, IA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160016
Location802 Kenyon RdFort Dodge, IA 50501 · Webster County
Emergency services Birthing friendly

Allen Hospital

Acute Care Hospitals · Waterloo, IA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160110
Location1825 Logan AvenueWaterloo, IA 50703 · Black Hawk County
Emergency services Birthing friendly

Community Memorial Hospital Medical Center

Critical Access Hospitals · Sumner, IA
OwnershipVoluntary non-profit - Private
CMS Certification Number161320
Location909 West First StreetSumner, IA 50674 · Bremer County
Emergency services

Humboldt County Memorial Hospital

Critical Access Hospitals · Humboldt, IA
OwnershipVoluntary non-profit - Other
CMS Certification Number161334
Location1000 North 15th StreetHumboldt, IA 50548 · Humboldt County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08755 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%70 patients5/55-star benchmark: 100%
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 3

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

GABRIELLE CORPUZ PA-C
Internal Medicine (Gastroenterology)
425 LAKEHURST RD
TOMS RIVER, NJ 08755
Ocean County (732) 281-1590
WENDY LOUISE STRATTON APN
Nurse Practitioner (Primary Care)
425 LAKEHURST RD
TOMS RIVER, NJ 08755
Ocean County (732) 281-1590
OCEAN FAMILY GASTROENTEROLOGY PC
Internal Medicine (Gastroenterology)
425 LAKEHURST RD
TOMS RIVER, NJ 08755
Ocean County (732) 281-1590

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 Kavan Patel's NPI number?

The NPI number for Kavan Patel is 1437541406. It was assigned to this individual provider in the NPPES registry on February 26, 2015.

Where is Kavan Patel located?

Kavan Patel practices at 425 Lakehurst Rd, Toms River, NJ 08755. The listed phone number is (732) 281-1590.

What is Kavan Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Kavan Patel enrolled in Medicare?

Yes. Kavan Patel is registered in the Medicare PECOS enrollment system.

What insurance does Kavan Patel accept?

Health plans from Medica, Molina Healthcare and Quartz list Kavan 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 Kavan Patel affiliated with any hospitals?

According to CMS data, Kavan Patel is affiliated with Herrin Hospital, Trinity Regional Medical Center, Allen Hospital, Community Memorial Hospital Medical Center and Humboldt County Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Kavan Patel was last updated on April 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.