DR. NILESH J PATEL M.D.
NPI 1649327826
Orthopaedic Surgery in Edison, NJ

Q: What is Nilesh Patel's NPI number?

The NPI number for Nilesh Patel is 1649327826. It was assigned to this individual provider in the NPPES registry on January 3, 2007.

Q: What is Nilesh Patel's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Nilesh Patel was last updated on May 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since January 03, 2007PECOS EnrolledAccepts Medicare Assignment

69.66/100

CMS Quality Rating

10 PARSONAGE RD STE 500, EDISON, NJ 08837(732) 494-6226(732) 494-8762 Get Directions Write a Review

NPPES record last updated: May 7, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 7, 2026, May 19, 2025 (2 updates tracked since 2025).

On this page

About Dr. Nilesh J Patel M.d. NPPES

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

DR. NILESH J PATEL M.D. (NPI 1649327826) is an individual orthopaedic surgery provider in Edison, New Jersey, licensed in New Jersey (25MA07619500) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with St Joseph's University Medical Center Inc, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1649327826

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. NILESH J PATELCredential: M.D.

Location Address10 PARSONAGE RD STE 500Edison, NJ 08837-2475

Mailing Address90 Matawan Rd Ste 302Matawan, NJ 07747-2653 · (732) 441-7177 · Fax (732) 441-7165

Phone(732) 494-6226

Fax(732) 494-8762

Sole ProprietorNo

Medical School CMSOtherGraduated 1997

Enumeration DateJanuary 3, 2007

Last NPPES UpdateMay 7, 20262 updates tracked since enumeration

NPPES CertifiedMay 7, 2026

✔ NPI 1649327826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in NJ · 25MA07619500

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

10 PARSONAGE RD STE 500, Edison, NJ 08837

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health.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

Dr. Nilesh 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 ID2567375124

PECOS Enrollment IDI20031110000451

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

Medicare enrollment records show Nilesh Patel reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Edison Metuchen Orthopaedic Group PA

Same address

Orthopaedic Surgery

10 PARSONAGE RD STE 500
Edison, NJ 08837

Reassigned Medicare billing, New Jersey enrollment
6 clinicians in this Medicare group

NPI 1235289521 (732) 494-6226

Premier Brain And Spine, LLC

11 mi

Neurological Surgery

2500 MORRIS AVE STE 220
Union, NJ 07083

Reassigned Medicare billing, New Jersey enrollment
107 clinicians in this Medicare group

NPI 1922771377 (738) 906-9600

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 18

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.

316 services185 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

269 services98 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

217 services131 patients

Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112

This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.

216 services18 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

210 services149 patients

Therapy procedure using manual technique, each 15 minutes 97140

This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.

167 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.

142 services107 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

122 services84 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

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

108 services82 patients

Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care G0283

Electrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.

68 services11 patients

Hyaluronan or derivative, gel-one, for intra-articular injection, per dose J7326

Hyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.

62 services33 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

19 services11 patients

Aspiration and/or injection of fluid from medium joint 20605

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

15 services11 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

14 services14 patients

X-ray of lower leg, 2 views 73590

An X-ray of the lower leg, 2 views, is a quick, painless test that produces images of the bones in your lower leg. It helps to identify fractures, infections, or diseases. Two different angles are used to provide a comprehensive view of the leg's structure.

13 services13 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.

13 services13 patients

X-ray of thigh bone, minimum 2 views 73552

An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Joseph's University Medical Center Inc

Acute Care Hospitals · Paterson, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number310019

Location703 Main StPaterson, NJ 07503 · Passaic County

Birthing friendly

Jfk Medical Center

Acute Care Hospitals · Edison, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310108

Location65 James StreetEdison, NJ 08820 · Middlesex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08837 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

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$79.09 typical visit price

range $20.97 – $155.92

Typical copayment $19.77 (range $5.24 – $38.98)

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.

69.66/100

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

Individually scored

Quality

49.75

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Documentation of Current Medications in the Medical Record

74%4,434 patients3/55-star benchmark: 100%

e-Prescribing

97%174 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

30%514 patients2/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

30%2,198 patients2/55-star benchmark: 98%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 89% · 1,073 patients

Patients screened: 95% · 1,073 patients

23%86 patients1/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

85%719 patients4/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 552 patients

Patients totalRate: 0% · 552 patients

0%552 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 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Neuromuscular stimulator, electronic shock unit E0745

DME-Other DME · category DE000N

1 supplier12 claims12 services$69.26 avg. paid by Medicare

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361

DME-Orthotic Devices · category DF003N

2 suppliers11 claims11 services$194.23 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

MS. JENNIFER LYN PAVENTI DPT

Physical Therapist