DR. PRAGNESH A PATEL M.D.
NPI 1568529006
Internal Medicine - Interventional Cardiology in Jefferson City, TN

Q: What is Pragnesh Patel's NPI number?

The NPI number for Pragnesh Patel is 1568529006. It was assigned to this individual provider in the NPPES registry on January 3, 2007.

Q: Where is Pragnesh Patel located?

Pragnesh Patel practices at 120 Hospital Dr Ste 260, Jefferson City, TN 37760. The listed phone number is (423) 839-2525.

Q: What is Pragnesh Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Q: Is Pragnesh Patel enrolled in Medicare?

Yes. Pragnesh 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.

Q: What insurance does Pragnesh Patel accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 3 other insurers list Pragnesh 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.

Q: Is Pragnesh Patel affiliated with any hospitals?

According to CMS data, Pragnesh Patel is affiliated with Tennova Healthcare-Jefferson Memorial Hospital, Physicians Regional Medical Center and Tennova Healthcare - Newport Medical Center.

Q: When was this NPI record last updated?

The NPPES record for Pragnesh Patel was last updated on March 15, 2023. 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 January 03, 2007PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

120 HOSPITAL DR STE 260, JEFFERSON CITY, TN 37760(423) 839-2525(423) 839-2424 Get Directions Write a Review

NPPES record last updated: March 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Pragnesh A Patel M.d. NPPES

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

DR. PRAGNESH A PATEL M.D. (NPI 1568529006) is an individual interventional cardiology provider in Jefferson City, Tennessee, licensed in Tennessee (MD0000045390) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Tennova Healthcare-jefferson Memorial Hospital, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1568529006

Entity TypeIndividualMale

Primary Taxonomy207RI0011X

Provider Legal NameDR. PRAGNESH A PATELCredential: M.D.

Location Address120 HOSPITAL DR STE 260Jefferson City, TN 37760-5283

Mailing Address120 Hospital Dr Ste 260Jefferson City, TN 37760-5283 · (319) 331-8323 · Fax (423) 839-2424

Phone(423) 839-2525

Fax(423) 839-2424

Sole ProprietorYes

Medical School CMSOtherGraduated 1992

Enumeration DateJanuary 3, 2007

Last NPPES UpdateMarch 15, 2023

NPPES CertifiedMarch 15, 2023

✔ NPI 1568529006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RI0011X

License✔ Licensed in TN · MD0000045390

Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

120 HOSPITAL DR STE 260, Jefferson City, TN 37760

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

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. Pragnesh A 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 ID3577532191

PECOS Enrollment IDI20100217000377

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 32

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.

1,463 services554 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

554 services417 patients

Injection, regadenoson, 0.1 mg J2785

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

436 services109 patients

Technetium tc-99m sestamibi, diagnostic, per study dose A9500

Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.

352 services177 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

307 services303 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

306 services294 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

182 services178 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

177 services177 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

176 services176 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.

122 services122 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

114 services93 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

98 services88 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

94 services93 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

92 services91 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

92 services91 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.

88 services77 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.

71 services37 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

68 services68 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

63 services62 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.

49 services45 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system 93288

An evaluation of a pacemaker system examines how well your heart device is working. Single, dual, multiple lead, or leadless refers to the wires that deliver electrical pulses from the pacemaker to your heart. This check ensures your heart is receiving the right amount of support from the device.

34 services28 patients

Ultrasound of leg arteries or artery grafts 93925

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

34 services32 patients

Evaluation of cardiac rhythm monitor system 93291

The evaluation of a cardiac rhythm monitor system involves checking your heart's electrical activity. It's a non-invasive procedure that uses a device to record your heart's rhythm and rate. This helps identify any irregularities, ensuring your heart is functioning properly.

25 services21 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

24 services20 patients

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.

24 services24 patients

Electrocardiogram (ecg) 2-day continuous with review by health care professional 93227

An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.

22 services22 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

20 services19 patients

External shock to heart to regulate heart beat 92960

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

19 services16 patients

Removal of plaque in arteries of leg 37225

This procedure, known as atherectomy, involves clearing out plaque buildup in the leg arteries. Plaque can restrict blood flow, causing discomfort and potential health issues. A special device is inserted into the artery to carefully remove the plaque, improving blood circulation.

18 services13 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

16 services16 patients

Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel 93571

This procedure involves using ultrasound technology to examine the first blood vessel of your heart. It helps identify any abnormalities or issues, providing crucial information for diagnosis or treatment. It's a safe, non-invasive process.

16 services16 patients

Review by radiologist of abdominal aorta and both leg arteries image 75630

This procedure involves a radiologist examining images of your abdominal aorta and leg arteries. These images help identify any abnormalities or blockages in the arteries, ensuring proper blood flow for optimal health.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Tennova Healthcare-Jefferson Memorial Hospital

Acute Care Hospitals · Jefferson City, TN

2/5 CMS rating

OwnershipProprietary

CMS Certification Number440056

Location110 Hospital DriveJefferson City, TN 37760 · Jefferson County

Emergency services

Physicians Regional Medical Center

Acute Care Hospitals · Powell, TN

2/5 CMS rating

OwnershipProprietary

CMS Certification Number440120

Location7565 Dannaher Way PowellPowell, TN 37849 · Knox County

Emergency services Birthing friendly

Tennova Healthcare - Newport Medical Center

Acute Care Hospitals · Newport, TN

3/5 CMS rating

OwnershipProprietary

CMS Certification Number440153

Location435 2nd StNewport, TN 37821 · Cocke County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37760 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

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

100/100

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

Individually scored

Quality

94.46

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Controlling High Blood Pressure

75%769 patients4/55-star benchmark: 91%

Coronary Artery Disease (CAD): Beta-Blocker Therapy Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <= 40%)

95%58 patients4/55-star benchmark: 99%

e-Prescribing

92%947 patients2/55-star benchmark: 100%

Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

91%54 patients4/55-star benchmark: 100%

Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

91%57 patients4/55-star benchmark: 100%

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

41%437 patients3/55-star benchmark: 61%

Provide Patients Electronic Access to Their Health Information

100%618 patients5/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 948 patients

Patients totalRate: 0% · 948 patients

0%948 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.

Referred Medical Equipment & Supplies CMS DME claims 13

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