PAWAN D. PATEL M.D
NPI 1518114594
Internal Medicine in Bemidji, MN

NPI Status: Active since August 21, 2008

Contact Information

1300 ANNE ST NW
BEMIDJI, MN
ZIP 56601
Phone: (218) 333-5519
Fax: (218) 333-4961

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  • Individual
  • Male
  • Years of Experience 24
  • Internal Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About PAWAN PATEL

This page provides the complete NPI Profile along with additional information for Pawan Patel, an internist established in Bemidji, Minnesota with a medical specialization in Internal Medicine and more than 24 years of experience. The healthcare provider is registered in the NPI registry with number 1518114594 assigned on August 2008. The practitioner's primary taxonomy code is 207R00000X with license number 54548 (MN). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1518114594
Provider Name
PAWAN D. PATEL M.D
Gender
Male
Entity Type
Individual
Location Address
1300 ANNE ST NW BEMIDJI, MN 56601
Location Phone
(218) 333-5519
Location Fax
(218) 333-4961
Mailing Address
1250 HENNEPIN AVE APT 301 MINNEAPOLIS, MN 55403
Mailing Phone
(773) 971-4550
Medical School Name
OTHER
Graduation Year
2002
Is Sole Proprietor?
No
Enumeration Date
08-21-2008
Last Update Date
03-27-2017
Code Navigator

An internist like Pawan Patel is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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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

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
54548
License State
MN
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Bronze Share - HMO
  • Essentia Choice Care with Medica Expanded Bronze Standard - HMO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Gold Share - HMO
  • Essentia Choice Care with Medica Gold Standard - HMO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Silver Share - HMO
  • Essentia Choice Care with Medica Silver Standard - HMO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze HSA - EPO
  • Medica Individual Choice Bronze Share - EPO
  • Medica Individual Choice Bronze Share - HMO
  • Medica Individual Choice Expanded Bronze Standard - EPO
  • Medica Individual Choice Expanded Bronze Standard - HMO
  • Medica Individual Choice Gold $0 Copay PCP Visits - EPO
  • Medica Individual Choice Gold $0 Copay PCP Visits - HMO
  • Medica Individual Choice Gold Share - EPO
  • Medica Individual Choice Gold Share - HMO
  • Medica Individual Choice Gold Standard - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Pawan Patel 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.

Pawan Patel 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: 5991974503

    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: I20110815000938, I20240501000223

    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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Unknown

  • Other-Enteral and Parenteral (OB005N)

    Enteral nutrition infusion pump, any type (HCPCS:B9002)

    2 DME suppliers used 26 Medicare Claims 26 Services Paid

Durable Medical Equipment

  • DME-Hospital Beds (DB000N)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    3 DME suppliers used 24 Medicare Claims 24 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing (HCPCS:E0434)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing (HCPCS:E0439)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Other DME (DE000N)

    Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery (HCPCS:E0550)

    2 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Other DME (DE000N)

    Respiratory suction pump, home model, portable or stationary, electric (HCPCS:E0600)

    3 DME suppliers used 14 Medicare Claims 14 Services Paid

  • DME-Other DME (DE000N)

    Iv pole (HCPCS:E0776)

    2 DME suppliers used 13 Medicare Claims 13 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 612 times for 105 patients

Follow-up hospital inpatient care per day, typically 35 minutes

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.

This service was performed 92 times for 21 patients

Hospital discharge day management, more than 30 minutes

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.

This service was performed 17 times for 17 patients

Initial hospital inpatient care per day, typically 50 minutes

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.

This service was performed 22 times for 22 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.9 for a new patient copayment and $24.65 for an established patient copayment.

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 56601 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $127.61
  • Minimum New Patient Price $56
  • Maximum New Patient Price $168.28
  • Average New Patient Copayment $31.9
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.07

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $98.61
  • Minimum Established Patient Price $18.32
  • Maximum Established Patient Price $138.04
  • Average Established Patient Copayment $24.65
  • Minimum Established Patient Copayment $4.58
  • Maximum Established Patient Copayment $34.51

* 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.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Pawan Patel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTH MEMORIAL HEALTH HOSPITAL3300 OAKDALE NORTH
ROBBINSDALE, MN 55422
(763) 520-5200Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1518114594, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
1
Doubled → 2
Pos 4
8
Unchanged
Pos 5
1
Doubled → 2
Pos 6
1
Unchanged
Pos 7
4
Doubled → 8
Pos 8
5
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 4 → 8 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 2 + 8 + 2 + 1 + 8 + 5 + 1 + 8 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1518114594.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Registered Nurse
1300 ANNE ST NW
BEMIDJI, MN 56601
Nurse Anesthetist, Certified Registered
1300 ANNE ST NW
BEMIDJI, MN 56601
Nurse Anesthetist, Certified Registered
1300 ANNE ST NW
BEMIDJI, MN 56601
Nurse Anesthetist, Certified Registered
1300 ANNE ST NW
BEMIDJI, MN 56601
Dietitian, Registered
1300 ANNE ST NW
BEMIDJI, MN 56601
Dietitian, Registered
1300 ANNE ST NW
BEMIDJI, MN 56601
Dietitian, Registered
1300 ANNE ST NW
BEMIDJI, MN 56601
Specialist
1300 ANNE ST NW
BEMIDJI, MN 56601
Nurse Anesthetist, Certified Registered
1300 ANNE ST NW
BEMIDJI, MN 56601
Internal Medicine
1300 ANNE ST NW
BEMIDJI, MN 56601
Physical Therapist
1300 ANNE ST NW
BEMIDJI, MN 56601
Family Medicine
1300 ANNE ST NW
BEMIDJI, MN 56601
Family Medicine
1300 ANNE ST NW
BEMIDJI, MN 56601
Prosthetic/Orthotic Supplier
1300 ANNE ST NW
BEMIDJI, MN 56601
Physical Medicine & Rehabilitation
1300 ANNE ST NW
BEMIDJI, MN 56601
Internal Medicine
1300 ANNE ST NW
BEMIDJI, MN 56601
Nurse Anesthetist, Certified Registered
1300 ANNE ST NW
BEMIDJI, MN 56601
Non-Pharmacy Dispensing Site
1300 ANNE ST NW
BEMIDJI, MN 56601
Physician Assistant (Medical)
1300 ANNE ST NW
BEMIDJI, MN 56601
Family Medicine
1300 ANNE ST NW
BEMIDJI, MN 56601

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1518114594, enumerated as an "individual" on August 21, 2008.

The provider is located at 1300 ANNE ST NW BEMIDJI, MN 56601 and the phone number is (218) 333-5519.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield and Medica. Please consult your insurance carrier or call the provider to verify.

Pawan Patel is affiliated with: NORTH MEMORIAL HEALTH HOSPITAL.