CHETAN P PATEL MD NPI 1639156516

Internal Medicine (Cardiovascular Disease) in Painesville, OH

NPI 1639156516 Individual Male Years of Experience 31 Internal Medicine Cardiovascular Disease PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting CLIA Number 36D1098666 CLIA Certificate of Waiver

About CHETAN PATEL

Chetan Patel is an internal medicine provider established in Painesville, Ohio and his medical specialization is internal medicine (cardiovascular disease) with more than 31 years of experience. The NPI number of Chetan Patel is 1639156516 and was assigned on December 2005. The practitioner's primary taxonomy code is 207RC0000X with license number 35070370P (OH). The provider is registered as an individual and his NPI record was last updated one year ago.

An internist like Chetan P Patel Md is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Chetan Patel is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Chetan Patel is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Lake Health, Lake Health Beachwood Medical Center, Cleveland Clinic and University Hospitals Ahuja Medical Center.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: care plan, coronary artery disease (cad): antiplatelet therapy, documentation of current medications in the medical record, e-prescribing, health information exchange exclusion, implementation of medication management practice improvements, medication reconciliation, onc direct review attestation, onc-acb surveillance attestation (optional), pain assessment and follow-up, patient-specific education, pi bonus for submission of eligible improvement activities using cehrt, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: screening for depression and follow-up plan, preventive care and screening: unhealthy alcohol use: screening & brief counseling, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patient access, secure messaging, security risk analysis, syndromic surveillance reporting and tcpi participation. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The CLIA number of Chetan P Patel Md is 36D1098666 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Chetan P Patel Md to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1639156516

Provider Name CHETAN P PATEL MD
Provider Location Address7879 AUBURN ROAD 1A PAINESVILLE, OH 44077
Provider Mailing Address7879 AUBURN RD SUITE 1A PAINESVILLE, OH 44077
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1991
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date12-30-2005
Last Update Date05-06-2021


Primary Taxonomy

Taxonomy Code207RC0000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationCardiovascular Disease
License No.35070370P
License StateOH
Taxonomy DescriptionAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Business Address

CHETAN P PATEL MD
7879 AUBURN ROAD 1A
PAINESVILLE, OH
ZIP 44077
Phone: (440) 354-0944
Fax: (440) 354-2043

Get Directions


Mailing Address

CHETAN P PATEL MD
7879 AUBURN RD
SUITE 1A
PAINESVILLE, OH
ZIP 44077
Phone: (440) 354-0944
Fax: (440) 354-2043



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID840236618
PECOS Enrollment IDI20050701000192
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 1243Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report (HCPCS:93010)
  • 801Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 235Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
  • 67Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart (HCPCS:93458)
  • 46Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report (HCPCS:93280)
  • 26Catheter insertion of stents in major coronary artery or branch, accessed through the skin (HCPCS:92928)
  • 15Nuclear medicine study of vessels of heart using drugs or exercise multiple studies (HCPCS:78452)
  • 15Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report (HCPCS:93018)

Quality Reporting

The following quality measures meets Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Rate Number of Patients
Care Plan 99% 762
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 or provide an advance care plan
Coronary Artery Disease (CAD): Antiplatelet Therapy 71% 920
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
Documentation of Current Medications in the Medical Record 100% 2446
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing 98% 1074
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Medication Reconciliation 88% 129
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.
Pain Assessment and Follow-Up 93% 2446
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
Patient-Specific Education 5% 559
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 84% 1273
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 98% 1273
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling 91% 797
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
Provide Patient Access 96% 559
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 certain information.
Secure Messaging 39% 559
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 message sent by the patient (or the patient-authorized representative) during the performance period.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Chetan Patel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
LAKE HEALTH7590 AUBURN ROAD
CONCORD, OH 44077
(440) 953-9600Acute Care Hospitals360098
LAKE HEALTH BEACHWOOD MEDICAL CENTER25501 CHAGRIN BLVD
BEACHWOOD, OH 44122
(216) 545-4800Acute Care Hospitals360367
CLEVELAND CLINIC9500 EUCLID AVENUE
CLEVELAND, OH 44195
(216) 445-8400Acute Care Hospitals360180
UNIVERSITY HOSPITALS AHUJA MEDICAL CENTER3999 RICHMOND ROAD
BEACHWOOD, OH 44122
(216) 593-5510Acute Care Hospitals360359

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1639156516 is:

CLIA Number36D1098666
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0324090MEDICAID (05)OH

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.