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DR. PRATIK SHASHIKANT PATEL M.D.
NPI 1689012932
Emergency Medicine in Gainesville, FL

Active since June 10, 2013PECOS EnrolledAccepts Medicare Assignment
82.6/100
CMS Quality Rating
1329 SW 16TH ST STE 1210, BOX 100371, GAINESVILLE, FL 32610(352) 265-0559 Get Directions Write a Review

NPPES record last updated: October 14, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 14, 2020, Jan 23, 2017 (2 updates tracked since 2017).

About Dr. Pratik Shashikant Patel M.d. NPPES

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

DR. PRATIK SHASHIKANT PATEL M.D. (NPI 1689012932) is an individual emergency medicine provider in Gainesville, Florida, licensed in Indiana (01083350A) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Union Hospital Inc, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1689012932
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. PRATIK SHASHIKANT PATELCredential: M.D.
Location Address1329 SW 16TH ST STE 1210, BOX 100371Gainesville, FL 32610-0186
Mailing Address1329 Sw 16th St Ste 1210, Box 100371Gainesville, FL 32610-0186 · (352) 265-0559
Phone(352) 265-0559
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateJune 10, 2013
Last NPPES UpdateOctober 14, 20202 updates tracked since enumeration
NPPES CertifiedOctober 14, 2020
✔ NPI 1689012932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in IN · 01083350A✔ Licensed in FL · ME126466
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
1329 SW 16TH ST STE 1210, Gainesville, FL 32610
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Other Identifiers 1

Medicaid017514200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Oscar Insurance Company.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. Pratik Shashikant 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 ID3577798065
PECOS Enrollment IDI20170301000994, I20200320001132
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 5

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
460 services432 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
165 services158 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
136 services133 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
103 services101 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
15 services15 patients

Hospital Affiliations CMS Care Compare 5

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

Union Hospital Inc

Acute Care Hospitals · Terre Haute, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150023
Location1606 N Seventh StTerre Haute, IN 47804 · Vigo County
Emergency services Birthing friendly

Terre Haute Regional Hospital

Acute Care Hospitals · Terre Haute, IN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number150046
Location3901 S Seventh StTerre Haute, IN 47802 · Vigo County
Emergency services Birthing friendly

Ascension St Vincent Clay

Critical Access Hospitals · Brazil, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151309
Location1206 E National AveBrazil, IN 47834 · Clay County
Emergency services

Ascension St Vincent Salem

Critical Access Hospitals · Salem, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151314
Location911 N Shelby StSalem, IN 47167 · Washington County
Emergency services

Christus Southeast Texas- St Elizabeth

Acute Care Hospitals · Beaumont, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450034
Location2830 Calder AvenueBeaumont, TX 77702 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32610 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
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.

82.6/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.53
Improvement Activities40

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.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$86.49 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$30.45 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Pratik Patel's NPI number?

The NPI number for Pratik Patel is 1689012932. It was assigned to this individual provider in the NPPES registry on June 10, 2013.

Where is Pratik Patel located?

Pratik Patel practices at 1329 SW 16th St Ste 1210 Box 100371, Gainesville, FL 32610. The listed phone number is (352) 265-0559.

What is Pratik Patel's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Pratik Patel enrolled in Medicare?

Yes. Pratik 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 Pratik Patel accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and Oscar Insurance Company list Pratik 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 Pratik Patel affiliated with any hospitals?

According to CMS data, Pratik Patel is affiliated with Union Hospital Inc, Terre Haute Regional Hospital, Ascension St Vincent Clay, Ascension St Vincent Salem and Christus Southeast Texas- St Elizabeth.

When was this NPI record last updated?

The NPPES record for Pratik Patel was last updated on October 14, 2020. 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.