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PRANAVI PATEL M.D.
NPI 1780147744
Internal Medicine in Pennington, NJ

Active since April 08, 2019PECOS EnrolledAccepts Medicare Assignment
28.87/100
CMS Quality Rating
1 CAPITAL WAY, PENNINGTON, NJ 08534(609) 303-4000 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 19, 2024, Jan 13, 2023, Apr 8, 2019 (3 updates tracked since 2019).

About Pranavi Patel M.d. NPPES

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

PRANAVI PATEL M.D. (NPI 1780147744) is an individual internal medicine provider in Pennington, New Jersey, licensed in New Jersey (25MA12203700) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1780147744
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NamePRANAVI PATELCredential: M.D.
Location Address1 CAPITAL WAYPennington, NJ 08534-2520
Mailing Address2201 Hempstead TpkeEast Meadow, NY 11554-1859
Phone(609) 303-4000
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 8, 2019
Last NPPES UpdateAugust 19, 20243 updates tracked since enumeration
NPPES CertifiedAugust 19, 2024
✔ NPI 1780147744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in NJ · 25MA12203700✔ Licensed in NV · 22639
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1 CAPITAL WAY, Pennington, NJ 08534
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12201 Hempstead TpkeEast Meadow, NY 11554-1859 · Phone (516) 572-4835
Location 2750 Brunswick AveTrenton, NJ 08638-4143 · Phone (609) 394-6000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Pranavi 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 ID8729316187
PECOS Enrollment IDI20240905000104
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Pranavi Patel reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Capital Health Multispecialty Group
7.2 mi
Surgery
750 BRUNSWICK AVE
Trenton, NJ 08638
  • Reassigned Medicare billing, New Jersey enrollment
  • 600 clinicians in this Medicare group
NPI 1083072342 (609) 394-6000
Rwjbh Emergency Medicine Associates, LLC
21 mi
Emergency Medicine
3 EXECUTIVE DR, STE 400
Somerset, NJ 08873
  • Reassigned Medicare billing, New Jersey enrollment
  • 1,557 clinicians in this Medicare group
NPI 1912510041 (732) 867-9618
Nevada Acute Medical Services-Scherr 1 PC
2,198 mi
Hospitalist
2500 N TENAYA WAY
Las Vegas, NV 89128
  • Reassigned Medicare billing, Nevada enrollment
  • 156 clinicians in this Medicare group
NPI 1992244438 (865) 693-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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 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.
381 services137 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
71 services13 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.
68 services67 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.
30 services16 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.
27 services27 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08534 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

28.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities40
Cost12.91

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.

AARTI SANJEEV VADHAVKAR M.D.
Anesthesiology
1 CAPITAL WAY, DEPT OF ANESTHESIOLOGY, CAPITAL HEALTH HOPEWELL MEDICAL
PENNINGTON, NJ 08534
Mercer County (800) 637-2374
MRS. EMILY KATHERINE WARIAS NP
Nurse Practitioner
1 CAPITAL WAY
PENNINGTON, NJ 08534
Mercer County (609) 303-6000
DANIEL FINKE CRNA
Nurse Anesthetist, Certified Registered
1 CAPITAL WAY
PENNINGTON, NJ 08534
Mercer County (800) 637-2374
JENNIFER JIE XU DO
Emergency Medicine
1 CAPITAL WAY
PENNINGTON, NJ 08534
Mercer County (609) 303-4010
RICHU RAJU MD
Emergency Medicine
1 CAPITAL WAY
PENNINGTON, NJ 08534
Mercer County (609) 303-4000
SRIYA AMRUTA KOSARAJU MD
Student in an Organized Health Care Education/Training Program
1 CAPITAL WAY
PENNINGTON, NJ 08534
Mercer County (800) 637-2374
KAREN B GIQUINTO CRNP
Nurse Practitioner
1 CAPITAL WAY
PENNINGTON, NJ 08534
Mercer County (609) 303-4000
CANDICE A DISANTI CNM
Advanced Practice Midwife
1 CAPITAL WAY
PENNINGTON, NJ 08534
Mercer County (609) 303-4000

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 Pranavi Patel's NPI number?

The NPI number for Pranavi Patel is 1780147744. It was assigned to this individual provider in the NPPES registry on April 8, 2019.

Where is Pranavi Patel located?

Pranavi Patel practices at 1 Capital Way, Pennington, NJ 08534. The listed phone number is (609) 303-4000.

What is Pranavi Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pranavi Patel enrolled in Medicare?

Yes. Pranavi 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.

Which organizations bill Medicare for Pranavi Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pranavi Patel reassigns Medicare benefits to 3 organizations: Capital Health Multispecialty Group (Trenton, NJ), Rwjbh Emergency Medicine Associates, LLC (Somerset, NJ) and Nevada Acute Medical Services-Scherr 1 PC (Las Vegas, NV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pranavi Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pranavi Patel accept?

Health plans from Oscar Health list Pranavi 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.

When was this NPI record last updated?

The NPPES record for Pranavi Patel was last updated on August 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.