NIMISHA PATEL MD
NPI 1811126576
Hospitalist in Cumming, GA

Q: What is Nimisha Patel's NPI number?

The NPI number for Nimisha Patel is 1811126576. It was assigned to this individual provider in the NPPES registry on July 2, 2009.

Q: What is Nimisha Patel's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Nimisha Patel was last updated on April 13, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 02, 2009PECOS EnrolledAccepts Medicare Assignment

98.31/100

CMS Quality Rating

1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041(770) 844-3200(404) 851-6325 Get Directions Write a Review

NPPES record last updated: April 13, 2017. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Apr 13, 2017, Dec 18, 2015 (2 updates tracked since 2015).

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About Nimisha Patel Md NPPES

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

NIMISHA PATEL MD (NPI 1811126576) is an individual hospitalist provider in Cumming, Georgia, licensed in Georgia (069239) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1811126576

Entity TypeIndividualFemale

Primary Taxonomy208M00000X

Provider Legal NameNIMISHA PATELCredential: MD

Location Address1200 NORTHSIDE FORSYTH DRCumming, GA 30041-7659

Mailing Address1200 Northside Forsyth DrCumming, GA 30041-7659 · (770) 844-3200 · Fax (404) 851-6325

Phone(770) 844-3200

Fax(404) 851-6325

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateJuly 2, 2009

Last NPPES UpdateApril 13, 20172 updates tracked since enumeration

✔ NPI 1811126576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in GA · 069239

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 22229 (MS), 69239 (GA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1200 NORTHSIDE FORSYTH DR, Cumming, GA 30041

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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

Nimisha 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 ID4183875438

PECOS Enrollment IDI20130716000155

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 9

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.

677 services208 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.

143 services142 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.

58 services40 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.

46 services45 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

23 services22 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.

20 services18 patients

Hospital Affiliations CMS Care Compare

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110005

Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30041 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

98.31/100

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

Scored as part of a group practice

Quality

97.88

Improvement Activities

Cost

84.56

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers22 claims22 services$14.38 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers22 claims22 services$62.91 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 20

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

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