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DR. HERSHEL R PATEL MD
NPI 1801216072
Ophthalmology - Retina Specialist in Winter Haven, FL

Active since April 25, 2014PECOS EnrolledAccepts Medicare Assignment
94.37/100
CMS Quality Rating
250 AVENUE K SW STE 200, WINTER HAVEN, FL 33880(863) 297-5400(833) 989-0315 Get Directions Write a Review

NPPES record last updated: August 5, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 5, 2020, Jun 24, 2020, Jan 27, 2020 and 1 more (4 updates tracked since 2018).

About Dr. Hershel R Patel Md NPPES

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

DR. HERSHEL R PATEL MD (NPI 1801216072) is an individual retina specialist in Winter Haven, Florida, licensed in Florida (ME145015) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1801216072
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameDR. HERSHEL R PATELCredential: MD
Location Address250 AVENUE K SW STE 200Winter Haven, FL 33880-3919
Mailing Address250 Avenue K Sw Ste 200Winter Haven, FL 33880-3919 · (863) 297-5400 · Fax (833) 989-0315
Phone(863) 297-5400
Fax(833) 989-0315
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 25, 2014
Last NPPES UpdateAugust 5, 20204 updates tracked since enumeration
NPPES CertifiedAugust 5, 2020
✔ NPI 1801216072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License✔ Licensed in FL · ME145015
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License ME145015 (FL)
250 AVENUE K SW STE 200, Winter Haven, FL 33880
Open in Google Maps ↗

Secondary Practice Locations 3

Location 12815 Lakeland Hills BlvdLakeland, FL 33805-2224 · Phone (863) 297-5400 · Fax (833) 989-0315
Location 26719 Gall Blvd Ste 206Zephyrhills, FL 33542-2569 · Phone (863) 297-5400 · Fax (833) 989-0315
Location 34636 Bellwether LaneOxford, FL 34484 · Phone (863) 297-5400 · Fax (833) 989-0315

Other Identifiers 1

Medicaid106409100FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), UnitedHealthcare.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. Hershel 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 ID143578872
PECOS Enrollment IDI20200601001209
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 11

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
17,160 services82 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
1,642 services171 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
1,428 services502 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
1,310 services325 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.
529 services279 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.
522 services388 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33880 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
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.

94.37/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality83.49
Improvement Activities40

Patient Reviews User submitted

Reviews are submitted by site visitors and approved by a human moderator before publication.

Review by Carol ***** November 20, 2023

5/5
Helpful, knowledgeable. Easy to talk to, and welcomes questions.
Provider 5/5 Office Staff 5/5
Visited this provider? Share your experience.

Other Providers at the Same Location NPPES 2

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

MEHAK KHAN OD
Optometrist
250 AVENUE K SW STE 200
WINTER HAVEN, FL 33880
Polk County (863) 297-5400
LOGAN LAWRENCE CHRISTENSEN M.D.
Ophthalmology (Retina Specialist)
250 AVENUE K SW STE 200
WINTER HAVEN, FL 33880
Polk County (863) 297-5400

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 Hershel Patel's NPI number?

The NPI number for Hershel Patel is 1801216072. It was assigned to this individual provider in the NPPES registry on April 25, 2014.

Where is Hershel Patel located?

Hershel Patel practices at 250 Avenue K SW Ste 200, Winter Haven, FL 33880. The listed phone number is (863) 297-5400.

What is Hershel Patel's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Hershel Patel enrolled in Medicare?

Yes. Hershel 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.

What insurance does Hershel Patel accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Hershel 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 Hershel Patel was last updated on August 5, 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.