PRAFUL PATEL M.D.
NPI 1821020074
Obstetrics & Gynecology in Dothan, AL

Active since July 07, 2006PECOS EnrolledAccepts Medicare Assignment
1118 ROSS CLARK CIR, SUITE 600, DOTHAN, AL 36301(334) 793-3900(334) 793-5227 Get Directions Write a Review

NPPES record last updated: September 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2024, Jul 10, 2024, Aug 18, 2016 (3 updates tracked since 2016).

About Praful Patel M.d. NPPES

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

PRAFUL PATEL M.D. (NPI 1821020074) is an individual obstetrics & gynecology provider in Dothan, Alabama, licensed in Alabama (22261) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of South Alabama College Of Medicine (1997).

NPPES Registry Identity

NPI1821020074
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NamePRAFUL PATELCredential: M.D.
Location Address1118 ROSS CLARK CIR, SUITE 600Dothan, AL 36301-3007
Mailing Address1118 Ross Clark Cir, Suite 600Dothan, AL 36301-3007 · (334) 793-3900 · Fax (334) 793-5227
Fax(334) 793-5227
Sole ProprietorNo
Medical School CMSUniversity Of South Alabama College Of MedicineGraduated 1997
Enumeration DateJuly 7, 2006
Last NPPES UpdateSeptember 11, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2024
NPI 1821020074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License Licensed in AL · 22261
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1118 ROSS CLARK CIR, Dothan, AL 36301

Other Identifiers 4

Medicaid051502545AL
Other051502545AL · Bcbs
Medicaid009961150AL
Other51502546AL · Bcbs

Accepted 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

Praful 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 ID2163618034
PECOS Enrollment IDI20101118000698
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.
76 services63 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.
42 services21 patients
Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
29 services29 patients
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory Q0091
A Papanicolaou smear, often called a Pap smear, is a test to check for changes in cells. A small sample is gently collected from the lower region and sent to a lab for examination. This helps in early detection of potential health issues.
19 services19 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
15 services14 patients
Complete ultrasound scan of pelvis 76856
A complete ultrasound scan of the pelvis is a safe, non-invasive imaging procedure. It uses sound waves to create pictures of your lower abdomen area, helping doctors to evaluate and diagnose any potential issues. It's painless and usually takes about 30 minutes.
12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36301 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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.

Reported Quality Measures

Breast Cancer Screening
78%394 patients4/55-star benchmark: 93%
Cervical Cancer Screening
76%995 patients4/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
3%59 patients1/55-star benchmark: 87%
Controlling High Blood Pressure
62%100 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
97%2,130 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
25%1,442 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
27%1,733 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 71% · 1,197 patients
Patients screened: 78% · 1,197 patients
15%94 patients1/55-star benchmark: 100%
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.

Urology
1118 ROSS CLARK CIR, 500
DOTHAN, AL 36301
Internal Medicine (Cardiovascular Disease)
1118 ROSS CLARK CIR, STE 704
DOTHAN, AL 36301
Obstetrics & Gynecology
1118 ROSS CLARK CIR, SUITE 402
DOTHAN, AL 36301
Nurse Practitioner
1118 ROSS CLARK CIR, SUITE 303
DOTHAN, AL 36301
Nurse Practitioner (Adult Health)
1118 ROSS CLARK CIR, SUITE 100
DOTHAN, AL 36301
Nurse Anesthetist, Certified Registered
1118 ROSS CLARK CIR
DOTHAN, AL 36301
Anesthesiology
1118 ROSS CLARK CIR
DOTHAN, AL 36301
Obstetrics & Gynecology
1118 ROSS CLARK CIR, SUITE 600
DOTHAN, AL 36301

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 Praful Patel's NPI number?

The NPI number for Praful Patel is 1821020074. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Praful Patel located?

Praful Patel practices at 1118 Ross Clark Cir Suite 600, Dothan, AL 36301. The listed phone number is (334) 793-3900.

What is Praful Patel's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Praful Patel enrolled in Medicare?

Yes. Praful 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 Praful Patel accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 3 other insurers list Praful 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 Praful Patel was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.