PRIYA PATEL MD
NPI 1568025443
Family Medicine in Lavonia, GA

Q: What is Priya Patel's NPI number?

The NPI number for Priya Patel is 1568025443. It was assigned to this individual provider in the NPPES registry on April 17, 2019.

Q: What is Priya Patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Priya Patel was last updated on November 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 April 17, 2019PECOS EnrolledAccepts Medicare Assignment

12192 AUGUSTA RD, LAVONIA, GA 30553(706) 356-1072 Get Directions Write a Review

NPPES record last updated: November 22, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 22, 2022, Apr 17, 2019 (2 updates tracked since 2019).

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About Priya Patel Md NPPES

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

PRIYA PATEL MD (NPI 1568025443) is an individual family medicine provider in Lavonia, Georgia, licensed in Georgia (90788) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Gwinnett, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1568025443

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NamePRIYA PATELCredential: MD

Location Address12192 AUGUSTA RDLavonia, GA 30553-1209

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420

Phone(706) 356-1072

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateApril 17, 2019

Last NPPES UpdateNovember 22, 20222 updates tracked since enumeration

NPPES CertifiedNovember 22, 2022

✔ NPI 1568025443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 90788

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

12192 AUGUSTA RD, Lavonia, GA 30553

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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

Priya Patel Md 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 ID8820324940

PECOS Enrollment IDI20221202002721

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 4

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 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.

95 services53 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.

41 services26 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.

18 services18 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110087

Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County

Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Northside Hospital Duluth

Acute Care Hospitals · Duluth, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110252

Location3620 Howell Ferry RoadDuluth, GA 30096 · Gwinnett County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30553 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

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Other Providers at the Same Location NPPES 10

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

VICTORIA LYNN JORDAN FNP-C

Nurse Practitioner (Family)