PRITIBEN PATEL MD
NPI 1720469828
Family Medicine in Duarte, CA

Q: What is Pritiben Patel's NPI number?

The NPI number for Pritiben Patel is 1720469828. It was assigned to this individual provider in the NPPES registry on June 15, 2015.

Q: What is Pritiben Patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Pritiben Patel was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 15, 2015PECOS EnrolledAccepts Medicare Assignment

99.12/100

CMS Quality Rating

1500 DUARTE RD, DUARTE, CA 91010(626) 256-4673 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Dec 3, 2021, Nov 19, 2020, Mar 23, 2020 and 1 more (4 updates tracked since 2018).

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About Pritiben Patel Md NPPES

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

PRITIBEN PATEL MD (NPI 1720469828) is an individual family medicine provider in Duarte, California, licensed in California (A153457) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1720469828

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NamePRITIBEN PATELCredential: MD

Location Address1500 DUARTE RDDuarte, CA 91010-3012

Mailing AddressPo Box 512185Los Angeles, CA 90051-0185

Phone(626) 256-4673

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateJune 15, 2015

Last NPPES UpdateDecember 3, 20214 updates tracked since enumeration

NPPES CertifiedNovember 19, 2020

✔ NPI 1720469828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · A153457

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedHospitalistTaxonomy 208M00000X · License A153457 (CA)

1500 DUARTE RD, Duarte, CA 91010

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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

Pritiben Patel Md 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 ID1557617602

PECOS Enrollment IDI20180703002791

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 3

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.

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.

496 services130 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

86 services79 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.

41 services39 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91010 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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.

99.12/100

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

Scored as part of a group practice

Quality

85.23

Promoting Interoperability

100

Improvement Activities

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…

99%67 patients4/55-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 4

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers32 claims32 services$14.91 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers21 claims21 services$3.33 avg. paid by Medicare

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

3 suppliers32 claims32 services$68.33 avg. paid by Medicare

Lightweight wheelchair K0003

DME-Wheelchairs · category DD000N

1 supplier13 claims13 services$32.17 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.

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