DR. KALPESH MISTRY MD
NPI 1740717669
Family Medicine in Toccoa, GA

Q: What is Kalpesh Mistry's NPI number?

The NPI number for Kalpesh Mistry is 1740717669. It was assigned to this individual provider in the NPPES registry on May 23, 2017.

Q: What is Kalpesh Mistry'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 Kalpesh Mistry was last updated on June 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 May 23, 2017PECOS EnrolledAccepts Medicare Assignment

89.89/100

CMS Quality Rating

115 ROCK QUARRY RD, TOCCOA, GA 30577(706) 282-5815(706) 898-5716 Get Directions Write a Review

NPPES record last updated: June 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 30, 2020, May 23, 2017 (2 updates tracked since 2017).

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About Dr. Kalpesh Mistry Md NPPES

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

DR. KALPESH MISTRY MD (NPI 1740717669) is an individual family medicine provider in Toccoa, Georgia, licensed in Georgia (83153) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1740717669

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KALPESH MISTRYCredential: MD

Location Address115 ROCK QUARRY RDToccoa, GA 30577-8734

Mailing Address163 Hospital DrToccoa, GA 30577-6820 · (706) 282-4200

Phone(706) 282-5815

Fax(706) 898-5716

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateMay 23, 2017

Last NPPES UpdateJune 30, 20202 updates tracked since enumeration

NPPES CertifiedJune 30, 2020

✔ NPI 1740717669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 83153

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.

115 ROCK QUARRY RD, Toccoa, GA 30577

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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. Kalpesh Mistry 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 ID3971879248

PECOS Enrollment IDI20200709000300

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 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.

Removal of tissue from wound, 20.0 sq cm or less 97597

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

599 services100 patients

Removal of tissue from wound, each additional 20.0 sq cm 97598

This procedure involves the careful removal of damaged tissue from a wound, typically beyond an initial 20.0 sq cm. This is done to promote healing, prevent infection, and improve the function and appearance of the area surrounding the wound.

299 services32 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

138 services47 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.

104 services82 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

87 services62 patients

Removal of muscle and/or tissue, 20.0 sq cm or less 11043

This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.

56 services22 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

45 services40 patients

Removal of bone, 20.0 sq cm or less 11044

The procedure involves the surgical removal of a section of bone, up to 20.0 square cm in size. This may be necessary due to various reasons such as injury, infection, or to treat a disease. The process aims to alleviate pain, enhance mobility, or prevent the spread of disease.

42 services15 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

39 services29 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

39 services39 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

35 services31 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.

34 services34 patients

Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less 15271

This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.

25 services11 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.

24 services20 patients

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.

23 services22 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

21 services21 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

16 services16 patients

2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc U0002

This refers to a test for COVID-19, caused by the SARS-CoV-2 virus. The test identifies multiple types or subtypes of the virus, including all targets. It's not specifically based on the CDC's testing protocol. It helps determine if you're currently infected with the virus.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number110029

Location743 Spring StreetGainesville, GA 30501 · Hall County

Emergency services Birthing friendly

Piedmont Cartersville Medical Center

Acute Care Hospitals · Cartersville, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110030

Location960 Joe Frank Harris ParkwayCartersville, GA 30120 · Bartow County

Emergency services Birthing friendly

Stephens County Hospital

Acute Care Hospitals · Toccoa, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110032

Location163 Hospital DriveToccoa, GA 30577 · Stephens County

Emergency services

Northeast Georgia Medical Center Habersham

Acute Care Hospitals · Demorest, GA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110041

Location541 Historic Highway 441-NorthDemorest, GA 30535 · Habersham County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30577 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

89.89/100

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

Scored through an Alternative Payment Model

Quality

79.78

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

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

Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446

DME-Medical/Surgical Supplies · category DA023N

2 suppliers11 claims1,154 services$0.37 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 3

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

SYDNEY ELISE CAUDELL NP-C

Nurse Practitioner (Family)

115 ROCK QUARRY RD
TOCCOA, GA 30577

Stephens County (706) 282-5815

LARRY FRITCHMAN M.D.

Family Medicine

115 ROCK QUARRY RD
TOCCOA, GA 30577

Stephens County (706) 282-5815

STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP, LLC

Preventive Medicine (Occupational Medicine)

115 ROCK QUARRY RD
TOCCOA, GA 30577

Stephens County (706) 282-5815

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 Kalpesh Mistry's NPI number?

The NPI number for Kalpesh Mistry is 1740717669. It was assigned to this individual provider in the NPPES registry on May 23, 2017.

Where is Kalpesh Mistry located?

Kalpesh Mistry practices at 115 Rock Quarry Rd, Toccoa, GA 30577. The listed phone number is (706) 282-5815.

What is Kalpesh Mistry's specialty?

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

Is Kalpesh Mistry enrolled in Medicare?

Yes. Kalpesh Mistry 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 Kalpesh Mistry accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Kalpesh Mistry 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 Kalpesh Mistry affiliated with any hospitals?

According to CMS data, Kalpesh Mistry is affiliated with Northeast Georgia Medical Center, Inc, Piedmont Cartersville Medical Center, Stephens County Hospital and Northeast Georgia Medical Center Habersham.

When was this NPI record last updated?

The NPPES record for Kalpesh Mistry was last updated on June 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.