DR. HETAL MAHENDRA PATEL M.D.
NPI 1801190962
Internal Medicine - Pulmonary Disease in Edison, NJ

Q: What is Hetal Patel's NPI number?

The NPI number for Hetal Patel is 1801190962. It was assigned to this individual provider in the NPPES registry on January 4, 2011.

Q: What is Hetal Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Hetal Patel was last updated on July 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 January 04, 2011PECOS EnrolledAccepts Medicare Assignment

89/100

CMS Quality Rating

34 SIMPSON AVE, EDISON, NJ 08817(732) 572-0369 Get Directions Write a Review

NPPES record last updated: July 13, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Hetal Mahendra Patel M.d. NPPES

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

DR. HETAL MAHENDRA PATEL M.D. (NPI 1801190962) is an individual pulmonary disease provider in Edison, New Jersey, licensed in New Jersey (25MA09720900) and active in the NPI registry since January 2011. He is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1801190962

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. HETAL MAHENDRA PATELCredential: M.D.

Location Address34 SIMPSON AVEEdison, NJ 08817-4430

Mailing Address34 Simpson AveEdison, NJ 08817-4430 · (732) 572-0369

Phone(732) 572-0369

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJanuary 4, 2011

Last NPPES UpdateJuly 13, 2015

✔ NPI 1801190962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in NJ · 25MA09720900

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 25MA09720900 (NJ)

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 25MA09720900 (NJ)

34 SIMPSON AVE, Edison, NJ 08817

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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

Dr. Hetal Mahendra 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 ID7113166885

PECOS Enrollment IDI20160322000026

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 14

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.

1,432 services311 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.

596 services281 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

411 services84 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.

262 services225 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

134 services112 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

134 services112 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

133 services111 patients

Inhalation treatment for airway obstruction or sputum production 94640

Inhalation treatment, also known as nebulizer therapy, helps clear airway obstructions and reduce sputum production. It involves breathing in medication through a device, turning it into a mist. This can open up the airways, making breathing easier and helping to cough out mucus.

53 services50 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.

52 services52 patients

Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation G0399

A Home Sleep Test (HST) with a Type III Portable Monitor is an unattended test that records your breathing, heart rate, and oxygen levels during sleep. This test uses a minimum of 4 channels to monitor these parameters, helping to diagnose sleep disorders.

45 services37 patients

Evaluation of use of breathing device 94664

The evaluation of a breathing device involves checking how effectively you're using it to manage your respiratory condition. It assesses the device's fit, your comfort, and your technique to ensure optimal results.

25 services21 patients

Smoking and tobacco use intensive counseling, more than 10 minutes 99407

This service involves an in-depth discussion about the risks of smoking and tobacco use, spanning over 10 minutes. It provides personalized strategies to quit smoking, including coping techniques for withdrawal symptoms and triggers. The goal is to support your journey towards a healthier lifestyle.

19 services13 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

15 services14 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310001

Location30 Prospect AveHackensack, NJ 07601 · Bergen County

Emergency services Birthing friendly

Clara Maass Medical Center

Acute Care Hospitals · Belleville, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310009

LocationOne Clara Maass DriveBelleville, NJ 07109 · Essex County

Emergency services Birthing friendly

Hackensack Meridian Health, Mountainside Medical

Acute Care Hospitals · Montclair, NJ

2/5 CMS rating

OwnershipProprietary

CMS Certification Number310054

Location1 Bay AvenueMontclair, NJ 07042 · Essex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08817 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

89/100

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

Scored as part of a group practice

Quality

72.48

Improvement Activities

Cost

85.53

Referred Medical Equipment & Supplies CMS DME claims 20

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

Tubing with integrated heating element for use with positive airway pressure device A4604