RUPA PANCHAL MD
NPI 1831118819
Internal Medicine in Howell, NJ

Q: What is Rupa Panchal's NPI number?

The NPI number for Rupa Panchal is 1831118819. It was assigned to this individual provider in the NPPES registry on July 19, 2006.

Q: What is Rupa Panchal's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Rupa Panchal was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since July 19, 2006PECOS EnrolledAccepts Medicare Assignment

200 CANDLEWOOD CMNS, HOWELL, NJ 07731(908) 312-0543(732) 901-3966 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Rupa Panchal Md NPPES

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

RUPA PANCHAL MD (NPI 1831118819) is an individual internal medicine provider in Howell, New Jersey, licensed in New Jersey (25MA07606800) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Cape Regional Medical Center Inc, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1831118819

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameRUPA PANCHALCredential: MD

Location Address200 CANDLEWOOD CMNSHowell, NJ 07731-2169

Mailing Address5 Elkridge WayManalapan, NJ 07726-3179 · (732) 567-5853 · Fax (732) 901-3966

Phone(908) 312-0543

Fax(732) 901-3966

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateJuly 19, 2006

Last NPPES UpdateMarch 10, 2025

NPPES CertifiedMarch 10, 2025

✔ NPI 1831118819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NJ · 25MA07606800

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

200 CANDLEWOOD CMNS, Howell, NJ 07731

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Imperial Insurance Companies, Inc., Oscar Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Rupa Panchal 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 ID3779564927

PECOS Enrollment IDI20040525001154, I20230407000166

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.

Medicare Billing Reassignments

Medicare enrollment records show Rupa Panchal reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rupa J Panchal MD PC

Same address

Internal Medicine

200 CANDLEWOOD CMNS STE 206
Howell, NJ 07731

Reassigned Medicare billing, New Jersey enrollment

NPI 1225362361 (908) 312-0543

Ocean Family & Geriatric Associates LLC

13 mi

Internal Medicine

20 HOSPITAL DRIVE SUITE 3
Toms River, NJ 08753

Reassigned Medicare billing, New Jersey enrollment
15 clinicians in this Medicare group

NPI 1740321645 (732) 341-9900

Hackensack Meridian Health Medical Group - Primary Care PC

15 mi

Family Medicine

331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701

Reassigned Medicare billing, New Jersey enrollment
689 clinicians in this Medicare group

NPI 1336203538 (732) 807-0800

Plover Inpatient Services LLC

46 mi

Emergency Medicine

1 BAY AVE
Montclair, NJ 07042

Reassigned Medicare billing, New Jersey enrollment
252 clinicians in this Medicare group

NPI 1134534688 (954) 939-5000

Emergency Medicine Associates P.A., P.C.

183 mi

Emergency Medicine

3300 GALLOWS RD
Falls Church, VA 22042

Reassigned Medicare billing, Virginia enrollment
1,294 clinicians in this Medicare group

NPI 1134117393 (703) 776-4001

Usacs Integrated Acute Care Services Of Texas, PLLC

1,482 mi

Internal Medicine

1401 MEDICAL PKWY
Cedar Park, TX 78613

Reassigned Medicare billing, Texas enrollment
828 clinicians in this Medicare group

NPI 1801300322 (330) 493-4443

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

418 services162 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

258 services55 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.

209 services197 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.

204 services149 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.

172 services126 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.

95 services44 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.

91 services78 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.

85 services74 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

42 services21 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

41 services39 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

28 services27 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.

17 services17 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

16 services12 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.

14 services14 patients

Hospital Affiliations CMS Care Compare 5

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

Cape Regional Medical Center Inc

Acute Care Hospitals · Cape May Court House, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310011

LocationTwo Stone Harbor BlvdCape May Court House, NJ 08210 · Cape May County

Emergency services

Community Medical Center

Acute Care Hospitals · Toms River, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310041

Location99 Rt 37 WestToms River, NJ 08755 · Ocean County

Emergency services Birthing friendly

Ocean Medical Center

Acute Care Hospitals · Brick, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number310052

Location425 Jack Martin BlvdBrick, NJ 08724 · Ocean County

Emergency services Birthing friendly

Jersey Shore University Medical Center

Acute Care Hospitals · Neptune, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310073

Location1945 State Route 33Neptune, NJ 07753 · Monmouth County

Emergency services Birthing friendly

Baptist Medical Center

Acute Care Hospitals · San Antonio, TX

4/5 CMS rating

OwnershipProprietary

CMS Certification Number450058

Location111 Dallas StreetSan Antonio, TX 78205 · Bexar County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07731 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

$140.34 typical visit price

range $61.59 – $185.05

Typical copayment $35.08 (range $15.39 – $46.26)

Most-billed visit code 99204

Established Patient

$107.94 typical visit price

range $20.08 – $150.98

Typical copayment $26.98 (range $5.02 – $37.74)

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

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.

80%509 patients3/55-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.

54%208 patients3/55-star benchmark: 99%

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…

36%208 patients2/55-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…

0%208 patients1/55-star benchmark: 59%

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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers11 claims23 services$5.42 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers13 claims14 services$44.95 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

1 supplier14 claims14 services$61.25 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$14.06 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

1 supplier12 claims12 services$6.17 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

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

SHMUEL KRASNER DC

Chiropractor

200 CANDLEWOOD CMNS
HOWELL, NJ 07731

Monmouth County (732) 630-5099

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 Rupa Panchal's NPI number?

The NPI number for Rupa Panchal is 1831118819. It was assigned to this individual provider in the NPPES registry on July 19, 2006.

Where is Rupa Panchal located?

Rupa Panchal practices at 200 Candlewood Cmns, Howell, NJ 07731. The listed phone number is (908) 312-0543.

What is Rupa Panchal's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Rupa Panchal enrolled in Medicare?

Yes. Rupa Panchal 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.

Which organizations bill Medicare for Rupa Panchal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rupa Panchal reassigns Medicare benefits to 6 organizations: Rupa J Panchal MD PC (Howell, NJ), Ocean Family & Geriatric Associates LLC (Toms River, NJ), Hackensack Meridian Health Medical Group - Primary Care PC (Red Bank, NJ), Plover Inpatient Services LLC (Montclair, NJ), Emergency Medicine Associates P.A., P.C. (Falls Church, VA) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rupa Panchal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Rupa Panchal accept?

Health plans from Blue Cross and Blue Shield of Texas, Imperial Insurance Companies, Inc., Oscar Health and Sendero Health Plans, Local Nonprofit list Rupa Panchal 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.

Is Rupa Panchal affiliated with any hospitals?

According to CMS data, Rupa Panchal is affiliated with Cape Regional Medical Center Inc, Community Medical Center, Ocean Medical Center, Jersey Shore University Medical Center and Baptist Medical Center.

When was this NPI record last updated?

The NPPES record for Rupa Panchal was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.