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DR. NISHA RAMAN PATEL M.D.
NPI 1518173079
Ophthalmology in Reston, VA

Active since May 14, 2007PECOS EnrolledAccepts Medicare Assignment
12110 SUNSET HILLS RD, SUITE C50, RESTON, VA 20190(703) 834-9777(703) 834-8187 Get Directions Write a Review

NPPES record last updated: March 23, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Nisha Raman Patel M.d. NPPES

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

DR. NISHA RAMAN PATEL M.D. (NPI 1518173079) is an individual ophthalmology provider in Reston, Virginia, licensed in Virginia (0101241432) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Inova Fairfax Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1518173079
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NameDR. NISHA RAMAN PATELCredential: M.D.
Location Address12110 SUNSET HILLS RD, SUITE C50Reston, VA 20190-5852
Mailing Address12110 Sunset Hills Rd, Suite C50Reston, VA 20190-5852 · (703) 834-9777 · Fax (703) 834-8187
Phone(703) 834-9777
Fax(703) 834-8187
Sole ProprietorYes
Medical School CMSOtherGraduated 2001
Enumeration DateMay 14, 2007
Last NPPES UpdateMarch 23, 2015
✔ NPI 1518173079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in VA · 0101241432✔ Licensed in NY · 240173
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
12110 SUNSET HILLS RD, Reston, VA 20190
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Other Identifiers 1

Medicare PIN022205J82VA

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. Nisha Raman Patel M.d. 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 ID3678668365
PECOS Enrollment IDI20070926000505, I20180820001694
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 11

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 problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
261 services120 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
131 services124 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
62 services61 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.
62 services62 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
47 services46 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
43 services31 patients

Hospital Affiliations CMS Care Compare

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

Inova Fairfax Hospital

Acute Care Hospitals · Falls Church, VA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490063
Location3300 Gallows RoadFalls Church, VA 22042 · Fairfax County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20190 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
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

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
0%223 patients1/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
0%225 patients1/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
89%3,167 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%512 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%753 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
96%524 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 55% · 598 patients
61%598 patients
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
67%524 patients3/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 414 patients
0%414 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.

DR. JACQUELINE D. GRIFFITHS MD
Ophthalmology
12110 SUNSET HILLS RD, SUITE C-50
RESTON, VA 20190
Fairfax County (703) 834-9777
STACEY E. SIMMS O.D.
Optometrist
12110 SUNSET HILLS RD, SUITE C-50
RESTON, VA 20190
Fairfax County (703) 834-9777
DR. ALICE S. OH OD
Optometrist
12110 SUNSET HILLS RD, #50
RESTON, VA 20190
Fairfax County (703) 834-9777

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 Nisha Patel's NPI number?

The NPI number for Nisha Patel is 1518173079. It was assigned to this individual provider in the NPPES registry on May 14, 2007.

Where is Nisha Patel located?

Nisha Patel practices at 12110 Sunset Hills Rd Suite C50, Reston, VA 20190. The listed phone number is (703) 834-9777.

What is Nisha Patel's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Nisha Patel enrolled in Medicare?

Yes. Nisha 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.

Is Nisha Patel affiliated with any hospitals?

According to CMS data, Nisha Patel is affiliated with Inova Fairfax Hospital.

When was this NPI record last updated?

The NPPES record for Nisha Patel was last updated on March 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.