DR. KUNAL PATEL M.D.
NPI 1548600240
Internal Medicine - Pulmonary Disease in Pleasant Prairie, WI

Q: What is Kunal Patel's NPI number?

The NPI number for Kunal Patel is 1548600240. It was assigned to this individual provider in the NPPES registry on June 27, 2013.

Q: What is Kunal Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Kunal Patel was last updated on January 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 27, 2013PECOS EnrolledAccepts Medicare Assignment

89.41/100

CMS Quality Rating

9555 76TH ST, PLEASANT PRAIRIE, WI 53158(262) 577-8300(262) 577-8414 Get Directions Write a Review

NPPES record last updated: January 24, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Kunal Patel M.d. NPPES

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

DR. KUNAL PATEL M.D. (NPI 1548600240) is an individual pulmonary disease provider in Pleasant Prairie, Wisconsin, licensed in Illinois (036141107) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and is a graduate of Other (2012).

NPPES Registry Identity

NPI1548600240

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. KUNAL PATELCredential: M.D.

Location Address9555 76TH STPleasant Prairie, WI 53158-1984

Mailing Address9555 76th StPleasant Prairie, WI 53158-1984 · (262) 577-8300 · Fax (262) 577-8414

Phone(262) 577-8300

Fax(262) 577-8414

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateJune 27, 2013

Last NPPES UpdateJanuary 24, 2024

NPPES CertifiedJanuary 24, 2024

✔ NPI 1548600240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in IL · 036141107

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 036141107 (IL)

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 036141107 (IL)

9555 76TH ST, Pleasant Prairie, WI 53158

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Other Identifiers 1

Other82697-20WI · Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kunal 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 ID8426342502

PECOS Enrollment IDI20230913001780

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.

Medicare Billing Reassignments

Medicare enrollment records show Kunal Patel reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Froedtert South, Inc.

5.4 mi

Family Medicine

6308 8TH AVE
Kenosha, WI 53143

Reassigned Medicare billing, Wisconsin enrollment
212 clinicians in this Medicare group

NPI 1558305284 (262) 656-2718

Waukegan Clinic Corp

14 mi

Family Medicine

1324 N SHERIDAN RD
Waukegan, IL 60085

Reassigned Medicare billing, Illinois enrollment
166 clinicians in this Medicare group

NPI 1306937289 (847) 360-3000

Mount Sinai Community Foundation

35 mi

Family Medicine

1400 E. GOLF RD, SUITE 118
Des Plaines, IL 60016

Reassigned Medicare billing, Illinois enrollment
646 clinicians in this Medicare group

NPI 1134164841 (847) 635-2001

Mercy Health System Corporation

57 mi

Mental Health (Including Community Mental Health Center)

903 MINERAL POINT AVE
Janesville, WI 53548

Reassigned Medicare billing, Wisconsin enrollment
1,155 clinicians in this Medicare group

NPI 1669685129 (608) 756-5555

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 16

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

220 services82 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.

186 services87 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.

115 services64 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

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.

62 services38 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.

42 services42 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

35 services35 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

35 services35 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

25 services22 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.

23 services23 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

22 services22 patients

Aspiration of initial secretion of lung airway using an endoscope 31645

This procedure involves using a thin, flexible tube called an endoscope to collect initial secretions from your lung airway. This helps doctors diagnose and treat respiratory conditions. It's a safe, minimally invasive procedure.

18 services18 patients

Aspiration of fluid from chest cavity using imaging guidance 32555

This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.

16 services13 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

14 services14 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

13 services13 patients

Computer-assisted image-guided navigation of lung airways using an endoscope 31627

This procedure involves the use of a special camera, called an endoscope, and computer technology to create real-time images of your lung airways. This helps doctors navigate through your lungs accurately, aiding in diagnosis or treatment.

12 services11 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Mercy Health System Corp

Acute Care Hospitals · Janesville, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520066

Location1000 Mineral Point AveJanesville, WI 53548 · Rock County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53158 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

89.41/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

76.66

Promoting Interoperability

100

Improvement Activities

Cost

71.14

Reported Quality Measures

Colorectal Cancer Screening

40%308 patients2/55-star benchmark: 88%

Controlling High Blood Pressure

91%181 patients5/55-star benchmark: 91%

Diabetes: Eye Exam

37%63 patients2/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

33%63 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

87%908 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

19%263 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

36%512 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

46%435 patients4/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 93% · 405 patients

Patients screened: 100% · 405 patients

65%74 patients3/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

81%140 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 1% · 276 patients

Patients totalRate: 6% · 281 patients

6%281 patients4/55-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.

Referred Medical Equipment & Supplies CMS DME claims 22

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

Tubing with integrated heating element for use with positive airway pressure device A4604