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SUKETU J PATEL M.D.
NPI 1629004791
Ophthalmology in Newnan, GA

Active since June 23, 2006PECOS EnrolledAccepts Medicare Assignment
15.52/100
CMS Quality Rating
2700 HIGHWAY 34 E STE 300, NEWNAN, GA 30265(678) 423-7700(678) 423-7710 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 2, 2025, Sep 3, 2020 (2 updates tracked since 2020).

About Suketu J Patel M.d. NPPES

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

SUKETU J PATEL M.D. (NPI 1629004791) is an individual ophthalmology provider in Newnan, Georgia, licensed in Georgia (55419) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Newnan Hospital, Inc, and is a graduate of University Of Texas Medical Branch At Galveston (2000).

NPPES Registry Identity

NPI1629004791
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameSUKETU J PATELCredential: M.D.
Location Address2700 HIGHWAY 34 E STE 300Newnan, GA 30265-2315
Mailing Address2700 Highway 34 E Ste 100Newnan, GA 30265-2315 · (678) 423-7700 · Fax (678) 423-7710
Phone(678) 423-7700
Fax(678) 423-7710
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 2000
Enumeration DateJune 23, 2006
Last NPPES UpdateApril 2, 20252 updates tracked since enumeration
NPPES CertifiedApril 2, 2025
✔ NPI 1629004791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in GA · 55419
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.
2700 HIGHWAY 34 E STE 300, Newnan, GA 30265
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Other Identifiers 1

Medicaid477988130FGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health, Oscar Health Insurance, Oscar Health Maintenance Organization of Florida 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

Suketu J 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 ID446218234
PECOS Enrollment IDI20041227000576
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 Reassignment

Medicare enrollment records show Suketu Patel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Thomas Eye Group PC
Same address
Ophthalmology
2700 HIGHWAY 34 E, BLDG 300
Newnan, GA 30265
  • Reassigned Medicare billing, Georgia enrollment
  • 70 clinicians in this Medicare group
NPI 1023128394 (678) 423-7700

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 13

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 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.
847 services719 patients
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.
392 services297 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.
342 services199 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.
297 services291 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
276 services162 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).
182 services178 patients

Hospital Affiliations CMS Care Compare

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

Piedmont Newnan Hospital, Inc

Acute Care Hospitals · Newnan, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110229
Location745 Poplar RoadNewnan, GA 30265 · Coweta County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30265 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
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.

15.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Promoting Interoperability0
Improvement Activities0
Cost51.73

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
100%141 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.

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 Suketu Patel's NPI number?

The NPI number for Suketu Patel is 1629004791. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Where is Suketu Patel located?

Suketu Patel practices at 2700 Highway 34 E Ste 300, Newnan, GA 30265. The listed phone number is (678) 423-7700.

What is Suketu Patel's specialty?

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

Is Suketu Patel enrolled in Medicare?

Yes. Suketu 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.

Which organization bills Medicare for Suketu Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Suketu Patel reassigns Medicare benefits to Thomas Eye Group PC (Newnan, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Suketu Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Suketu Patel accept?

Health plans from Oscar Health, Oscar Health Insurance, Oscar Health Maintenance Organization of Florida, Oscar Health Plan of North Carolina, Inc and Oscar Health Plan, Inc. and 3 other insurers list Suketu 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.

Is Suketu Patel affiliated with any hospitals?

According to CMS data, Suketu Patel is affiliated with Piedmont Newnan Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Suketu Patel was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.