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DR. SHYAM AJAY PATEL M.D., PH.D.
NPI 1669815874
Internal Medicine - Hematology & Oncology in Worcester, MA

Active since April 08, 2013PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
55 LAKE AVE N, WORCESTER, MA 01655(774) 442-3903 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 7, 2025, May 17, 2024, Nov 16, 2020 and 2 more (5 updates tracked since 2019).

About Dr. Shyam Ajay Patel M.d., Ph.d. NPPES

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

DR. SHYAM AJAY PATEL M.D., PH.D. (NPI 1669815874) is an individual hematology & oncology provider in Worcester, Massachusetts, licensed in Massachusetts (278331) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of Rutgers New Jersey Medical School (2013).

NPPES Registry Identity

NPI1669815874
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameDR. SHYAM AJAY PATELCredential: M.D., PH.D.
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977
Phone(774) 442-3903
Sole ProprietorNo
Medical School CMSRutgers New Jersey Medical SchoolGraduated 2013
Enumeration DateApril 8, 2013
Last NPPES UpdateMay 7, 20255 updates tracked since enumeration
NPPES CertifiedMay 7, 2025
✔ NPI 1669815874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in MA · 278331
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
55 LAKE AVE N, Worcester, MA 01655
Open in Google Maps ↗

Other Identifiers 1

Medicaid110155018AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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. Shyam Ajay Patel M.d., Ph.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 ID5294061818
PECOS Enrollment IDI20190719000765
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 8

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 high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
347 services65 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.
94 services38 patients
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.
39 services27 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.
38 services26 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
36 services11 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.
29 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220001
Location60 Hospital RoadLeominster, MA 01453 · Worcester County
Emergency services

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01655 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
$177.36 typical visit price
range $58.86 – $177.36
Typical copayment $44.34 (range $14.71 – $44.34)
Most-billed visit code 99205
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

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.

HILLARY R. IRONS MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
MS. EILEEN A. DUHAMEL NP
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-2710
EWA HRYNISZYN CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
HELEN COPSEY PA-C
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
DR. ADEPEJU GBADEBO CHAMPION M.D.
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-2731
SOWMYA KORAPATI
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-3550
LAYLA FAKHRZADEH M.D.
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
YOONYIE CHO M.D.
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-1000

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 Shyam Patel's NPI number?

The NPI number for Shyam Patel is 1669815874. It was assigned to this individual provider in the NPPES registry on April 8, 2013.

Where is Shyam Patel located?

Shyam Patel practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (774) 442-3903.

What is Shyam Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Shyam Patel enrolled in Medicare?

Yes. Shyam 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.

What insurance does Shyam Patel accept?

Health plans from Anthem Blue Cross and Blue Shield list Shyam 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 Shyam Patel affiliated with any hospitals?

According to CMS data, Shyam Patel is affiliated with Umass Memorial Healthalliance Hospitals and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Shyam Patel was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.