DR. PIYUSHKUMAR R PATEL MD
NPI 1790708279
Family Medicine in Gainesville, GA

Q: What is Piyushkumar Patel's NPI number?

The NPI number for Piyushkumar Patel is 1790708279. It was assigned to this individual provider in the NPPES registry on July 25, 2006.

Q: What is Piyushkumar 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 Piyushkumar Patel was last updated on October 22, 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.

Active since July 25, 2006PECOS EnrolledAccepts Medicare Assignment

597 S ENOTA DR NE, GAINESVILLE, GA 30501(770) 219-7777(770) 219-7778 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 22, 2020, Jul 27, 2018, May 23, 2018 (3 updates tracked since 2018).

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About Dr. Piyushkumar R Patel Md NPPES

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

DR. PIYUSHKUMAR R PATEL MD (NPI 1790708279) is an individual family medicine provider in Gainesville, Georgia, licensed in Georgia (058117) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Atrium Health Navicent The Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1790708279

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. PIYUSHKUMAR R PATELCredential: MD

Location Address597 S ENOTA DR NEGainesville, GA 30501

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420

Phone(770) 219-7777

Fax(770) 219-7778

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateJuly 25, 2006

Last NPPES UpdateOctober 22, 20203 updates tracked since enumeration

NPPES CertifiedOctober 22, 2020

✔ NPI 1790708279 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 · 058117

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.

597 S ENOTA DR NE, Gainesville, GA 30501

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Secondary Practice Locations 2

Location 1777 Hemlock St, Hospital Box 64Macon, GA 31201-2102 · Phone (478) 633-2097 · Fax (478) 633-7836

Location 22336 Dawson RdAlbany, GA 31707-2800 · Phone (229) 312-8755

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. Piyushkumar R 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 ID4082618368

PECOS Enrollment IDI20060828000471

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 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.

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.

133 services126 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

54 services54 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.

26 services25 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.

25 services24 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.

15 services15 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.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

Atrium Health Navicent The Medical Center

Acute Care Hospitals · Macon, GA

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110107

Location777 Hemlock StreetMacon, GA 31201 · Bibb County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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.

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

47%862 patients3/55-star benchmark: 85%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

16%162 patients1/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

93%4,153 patients4/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

98%258 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

52%3,762 patients3/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

24%2,701 patients2/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

100%3,762 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

8%3,762 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

18%3,762 patients

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.

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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Family Medicine