DR. PINAL P PATEL AU.D.
NPI 1730462573
Audiologist in Raleigh, NC
NPI Status: Active since September 27, 2011
Contact Information
10010 FALLS OF NEUSE RD
STE 12
RALEIGH, NC
ZIP 27614
Phone: (919) 766-8989
Fax: (919) 766-8896
- Individual
- Female
- Years of Experience 15
- Audiologist
- Accepts Insurance
- Accepts Medicare Approved Payment
About PINAL PATEL
This page provides the complete NPI Profile along with additional information for Pinal Patel, a provider established in Raleigh, North Carolina with a medical specialization in Audiologist and more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1730462573 assigned on September 2011. The practitioner's primary taxonomy code is 231H00000X with license number 10250 (NC). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1730462573
- Provider Name
- DR. PINAL P PATEL AU.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 10010 FALLS OF NEUSE RD STE 12 RALEIGH, NC 27614
- Location Phone
- (919) 766-8989
- Location Fax
- (919) 766-8896
- Mailing Address
- 4021 PINEY GAP DR CARY, NC 27519
- Mailing Phone
- (386) 235-5766
- Medical School Name
- OTHER
- Graduation Year
- 2011
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-27-2011
- Last Update Date
- 03-18-2019
- Code Navigator
Audiologists like Pinal Patel are experts in diagnosing issues related to various parts of the ear, including the outer, middle, and inner ear. They can identify conditions like vertigo, balance issues, hearing loss, and tinnitus, offering treatments based on a patient’s specific condition and severity. These specialists use specialized equipment to assess the cause and extent of hearing impairments, employing tools like audiometers to evaluate the range of frequencies and volumes a person can hear. In addition, audiologists counsel patients and their families, providing advice on managing and adapting to hearing loss.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Audiologist
- Taxonomy Code
- 231H00000X
- Type
- Speech, Language and Hearing Service Providers
- License No.
- 10250
- License State
- NC
- Taxonomy Description
- (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard A | Nationwide Doctors - PPO
- Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1730462573 | MEDICAID (05) | NC |
Medicare Participation & PECOS Enrollment Status
Pinal Patel is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
PECOS PAC ID: 3971731191
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20140115001833
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.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.
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $13.53 for a new patient copayment and $16.93 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 27614 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99202
- Average New Patient Price $54.12
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $13.53
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.72
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $16.93
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1730462573, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
RALEIGH, NC 27614
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1730462573, enumerated as an "individual" on September 27, 2011.
The provider is located at 10010 FALLS OF NEUSE RD STE 12 RALEIGH, NC 27614 and the phone number is (919) 766-8989.
Audiologist with taxonomy code 231H00000X.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
