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DR. PRAKASHKUMAR PATEL M.D.
NPI 1629079801
Psychiatry & Neurology - Neurology in Zephyrhills, FL

Active since August 10, 2005PECOS Enrolled
38156 MEDICAL CENTER AVE, ZEPHYRHILLS, FL 33540(813) 783-9799(813) 783-9793 Get Directions Write a Review

NPPES record last updated: July 9, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 9, 2021, Jun 22, 2021, Nov 27, 2020 (3 updates tracked since 2020).

About Dr. Prakashkumar Patel M.d. NPPES

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

DR. PRAKASHKUMAR PATEL M.D. (NPI 1629079801) is an individual neurology provider in Zephyrhills, Florida, licensed in Florida (ME86194) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Florida Hospital Zephyrhills, and maintains a secondary practice location in Amarillo.

NPPES Registry Identity

NPI1629079801
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. PRAKASHKUMAR PATELCredential: M.D.
Location Address38156 MEDICAL CENTER AVEZephyrhills, FL 33540-1380
Mailing Address38156 Medical Center AveZephyrhills, FL 33540-1380 · (813) 783-9799 · Fax (813) 783-9793
Phone(813) 783-9799
Fax(813) 783-9793
Sole ProprietorYes
Medical School CMSOtherGraduated 1991
Enumeration DateAugust 10, 2005
Last NPPES UpdateJuly 9, 20213 updates tracked since enumeration
NPPES CertifiedJuly 9, 2021
✔ NPI 1629079801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Licenses✔ Licensed in FL · ME86194✔ Licensed in TX · T0313
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
38156 MEDICAL CENTER AVE, Zephyrhills, FL 33540
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Secondary Practice Location 1

Location 11501 S Coulter StAmarillo, TX 79106-1770 · Phone (806) 354-1000 · Fax (806) 803-9557

Other Identifiers 1

Medicaid267730000FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Kansas, Inc., Dean Health Plan 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 (PECOS)

Dr. Prakashkumar Patel M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719881267
PECOS Enrollment IDI20031125000713, I20210908000934, I20251203004549
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

20

Medicare enrollment records show Prakashkumar Patel reassigns Medicare billing to 20 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sunrise Neurology PA
Same address
Neurology
38156 MEDICAL CENTER AVE
Zephyrhills, FL 33540
  • Reassigned Medicare billing, Florida enrollment
NPI 1063478279 (813) 783-9799
Kentuckyone Health Medical Group, Inc.
687 mi
Family Medicine
1401 HARRODSBURG RD
Lexington, KY 40504
  • Reassigned Medicare billing, Florida and Kentucky enrollments
  • 2 clinicians in this Medicare group
NPI 1104875970 (606) 330-7835
University Of Maryland Community Medical Group, Inc.
769 mi
Psychiatry
5 GARRETT AVE
La Plata, MD 20646
  • Reassigned Medicare billing, Maryland enrollment
  • 966 clinicians in this Medicare group
NPI 1679393854 (301) 609-4000
St Elizabeths Hospital Of The Hospital Sisters Of The Third Order
840 mi
Cardiovascular Disease
1 SAINT ELIZABETH BLVD
O Fallon, IL 62269
  • Reassigned Medicare billing, Florida enrollment
NPI 1326268202 (618) 234-2120
St Johns Hospital Of The Hospital Sisters Of The Third Order Of St F
903 mi
General Acute Care Hospital
800 EAST CARPENTER
Springfield, IL 62769
  • Reassigned Medicare billing, Florida enrollment
  • 2 clinicians in this Medicare group
NPI 1184606923 (217) 544-6464
Froedtert South, Inc.
1,036 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
Columbia St. Mary's Hospital Milwaukee, Inc
1,069 mi
Multi-Specialty
2350 N LAKE DR
Milwaukee, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Columbia St Marys Hospital Milwaukee Inc
  • 856 clinicians in this Medicare group
NPI 1023064482 (414) 585-1000
Ascension Medical Group-Southeast Wisconsin Inc
1,069 mi
Anesthesiology
2301 N LAKE DR
Milwaukee, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,343 clinicians in this Medicare group
NPI 1194473066 (414) 585-1000
Froedtert & the Medical College Of Wisconsin Community Physicians, Inc.
1,080 mi
Internal Medicine
W180N8000 TOWN HALL RD
Menomonee Falls, WI 53051
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,294 clinicians in this Medicare group
NPI 1568787448 (262) 255-2500
St Nicholas Hospital-Sisters Of The Third Order Of St Francis
1,112 mi
Internal Medicine
3100 SUPERIOR AVE
Sheboygan, WI 53081
  • Reassigned Medicare billing, Florida enrollment
  • 9 clinicians in this Medicare group
NPI 1447737762 (920) 459-5192

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 6

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.
166 services102 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.
86 services86 patients
Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth G0425
A telehealth consultation is a remote medical service where a doctor assesses your health condition through a video call. In an emergency or initial inpatient scenario, this typically lasts for about 30 minutes. This method allows for prompt, efficient care without needing to be physically present in a healthcare facility.
51 services50 patients
Needle measurement of electrical activity in arm or leg muscles, limited study 95885
This procedure, known as an electromyography (EMG), involves placing tiny needles into your arm or leg muscles to measure their electrical activity. It's a limited study, meaning only specific muscles are tested. This helps identify any muscle or nerve dysfunction.
26 services17 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.
24 services22 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Florida Hospital Zephyrhills

Acute Care Hospitals · Zephyrhills, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100046
Location7050 Gall BlvdZephyrhills, FL 33541 · Pasco County
Emergency services Birthing friendly

St Josephs Hospital

Acute Care Hospitals · Tampa, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100075
Location3001 W Martin Luther King Jr BlvdTampa, FL 33677 · Hillsborough County
Emergency services Birthing friendly

Adventhealth Tampa

Acute Care Hospitals · Tampa, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100173
Location3100 E Fletcher AveTampa, FL 33613 · Hillsborough County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33540 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
59%338 patients3/55-star benchmark: 100%
Dementia: Functional Status Assessment
Percentage of patients with dementia for whom an assessment of functional status* was performed at least once in the last 12 months
93%109 patients4/55-star benchmark: 100%
Diabetes/Pre-Diabetes Screening for Patients with DSP
Percentage of patients age 18 years and older with a diagnosis of distal symmetric polyneuropathy who had screening tests for diabetes (eg fasting blood sugar test, a hemoglobin A1C, or a 2 hour Glucose Tolerance Test) reviewed, requested or ordered when seen…
96%24 patients
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.
99%859 patients4/55-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.
97%1,706 patients4/55-star benchmark: 100%
Falls: Plan of Care
Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months
90%161 patients4/55-star benchmark: 100%
Falls: Risk Assessment
Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months
95%161 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
77%338 patients4/55-star benchmark: 99%
MEDICATION PRESCRIBED FOR ACUTE MIGRAINE ATTACK
Percentage of patients age 12 years and older with a diagnosis of migraine who were prescribed a guideline recommended medication for acute migraine attacks within the 12 month measurement period.
61%49 patients3/55-star benchmark: 90%
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.
97%1,706 patients4/55-star benchmark: 100%
Parkinson's Disease: Cognitive Impairment or Dysfunction Assessment
Percentage of all patients with a diagnosis of Parkinson's Disease [PD] who were assessed* for cognitive impairment or dysfunction in the past 12 months
21%28 patients1/55-star benchmark: 100%
Parkinson's Disease: Psychiatric Symptoms Assessment for Patients with Parkinson's Disease
Percentage of all patients with a diagnosis of Parkinson's Disease [PD] who were assessed* for psychiatric symptoms** in the past 12 months
79%28 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.
100%476 patients5/55-star benchmark: 100%
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…
54%476 patients3/55-star benchmark: 100%
Screening for Psychiatric or Behavioral Health Disorders
Percent of all visits for patients with a diagnosis of epilepsy where the patient was screened for psychiatric or behavioral disorders.
98%121 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
9%476 patients1/55-star benchmark: 79%
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

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

SUNRISE NEUROLOGY PA
Psychiatry & Neurology (Neurology)
38156 MEDICAL CENTER AVE
ZEPHYRHILLS, FL 33540
Pasco County (813) 783-9799

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 Prakashkumar Patel's NPI number?

The NPI number for Prakashkumar Patel is 1629079801. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Prakashkumar Patel located?

Prakashkumar Patel practices at 38156 Medical Center Ave, Zephyrhills, FL 33540. The listed phone number is (813) 783-9799.

What is Prakashkumar Patel's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Prakashkumar Patel enrolled in Medicare?

Yes. Prakashkumar Patel is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Prakashkumar Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prakashkumar Patel reassigns Medicare benefits to 20 organizations: Sunrise Neurology PA (Zephyrhills, FL), Kentuckyone Health Medical Group, Inc. (Lexington, KY), University Of Maryland Community Medical Group, Inc. (La Plata, MD), St Elizabeths Hospital Of The Hospital Sisters Of The Third Order (O Fallon, IL), St Johns Hospital Of The Hospital Sisters Of The Third Order Of St F (Springfield, IL) and 15 more organizations, listed in the Medicare section above. Each 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 Prakashkumar Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Prakashkumar Patel accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Kansas, Inc., Dean Health Plan, Health First Commercial Plans, Inc. and Network Health and 2 other insurers list Prakashkumar 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 Prakashkumar Patel affiliated with any hospitals?

According to CMS data, Prakashkumar Patel is affiliated with Florida Hospital Zephyrhills, St Josephs Hospital and Adventhealth Tampa.

When was this NPI record last updated?

The NPPES record for Prakashkumar Patel was last updated on July 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.