DR. PAYAL PATEL DMD
NPI 1831824804
Dentist - General Practice in Covington, KY

NPI Status: Active since July 22, 2022

Contact Information

1401 MADISON AVE
COVINGTON, KY
ZIP 41011
Phone: (859) 655-6100

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  • Individual
  • Female
  • Dentist
  • General Practice
  • Accepts Insurance
  • PECOS Enrolled

About PAYAL PATEL

This page provides the complete NPI Profile along with additional information for Payal Patel, a provider established in Covington, Kentucky with a medical specialization in Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1831824804 assigned on July 2022. The practitioner's primary taxonomy code is 1223G0001X with license number 11004 (KY). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1831824804
Provider Name
DR. PAYAL PATEL DMD
Gender
Female
Entity Type
Individual
Location Address
1401 MADISON AVE COVINGTON, KY 41011
Location Phone
(859) 655-6100
Mailing Address
215 E 11TH ST NEWPORT, KY 41071
Mailing Phone
(859) 655-6100
Is Sole Proprietor?
No
Enumeration Date
07-22-2022
Last Update Date
02-06-2024
Code Navigator

A dentist like Payal Patel is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
License No.
11004
License State
KY
Taxonomy Description
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1122300000XDental Providers

Dentist

DN122774 (GA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
  • Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 8500 for HSA - HMO
  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Catastrophic Essential (+ Incentives) - HMO
  • Anthem Catastrophic Pathway (+ Incentives) - EPO
  • Anthem Gold Essential 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Superior Dental Plan - PPO
  • BEST Life Essental Preferred Dental Plan - PPO
  • BEST Life Essental Value Dental Plan - PPO
  • BEST Life Essential Basic Dental Plan - PPO
  • BEST Life Essential Basic Dental - PPO
  • BEST Life Essential Basic Dental Plan - Indemnity
  • BEST Life Essential Basic Dental Plan - PPO
  • BEST Life Essential Value Dental Plan - PPO
  • BEST Life Essential Value Dental - PPO
  • BEST Life Essential Value Dental Plan - Indemnity
  • BEST Life Essential Value Dental Plan - PPO
  • BEST Life Preferred Dental - PPO
  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Preferred Dental Plan - Indemnity
  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Superior Dental - PPO
  • BEST Life Superior Dental Plan - PPO
  • BEST Life Superior Dental Plan - Indemnity
  • BEST Life Superior Dental Plan - PPO
  • Blue HSA Bronze - PPO
  • Blue Protect - PPO
  • Blue Saver Bronze - PPO
  • Blue Standardized Statewide Silver EPO - EPO
  • Blue Statewide Silver EPO - EPO
  • Blue Value Gold - PPO
  • Blue Value Silver - PPO
  • Blue Access Gold for Business - PPO
  • Blue Choice Platinum for Business - PPO
  • Blue HSA Silver for Business - PPO
  • Blue Saver Bronze for Business - PPO
  • Blue Saver Gold for Business - PPO
  • Blue Secure Gold for Business - PPO
  • Blue Secure Silver for Business - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Silver 6000 $20 Generic Drugs - HMO
  • HRI Essential Plus Plan - HMO
  • HRI Essential Plus Plan - PPO
  • HRI Preventive Family Plan - HMO
  • HRI Preventive Family Plan - PPO
  • HRI Total Care Plan - HMO
  • HRI Total Care Plan - PPO
  • Humana Dental Smart Choice - PPO
  • Humana Dental Smart Choice - Basic - PPO
  • Humana Dental Smart Choice - High - PPO
  • Humana Dental Smart Choice - Lite - PPO
  • Humana Dental Smart Choice - Low - PPO
  • Paramount Dental Essential Plus Plan - EPO
  • Paramount Dental Preventive Family Plan - EPO
  • Paramount Dental Total Care Plan - EPO
  • Lone Star - Smile Now - PPO
  • Smile Now Arizona - No Waiting Period PPO - PPO
  • Smile Now Michigan - No Waiting Period PPO - PPO
  • Smile Now Ohio - No Waiting Period PPO - PPO
  • Smile Now Texas- No Waiting Period Plan - PPO
  • Smile Now Utah - No Waiting Period PPO - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Payal Patel is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 41011 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.24
  • Minimum New Patient Price $52.76
  • Maximum New Patient Price $162.27
  • Average New Patient Copayment $20.56
  • Minimum New Patient Copayment $13.19
  • Maximum New Patient Copayment $40.56

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.24
  • Minimum Established Patient Price $16.53
  • Maximum Established Patient Price $131.99
  • Average Established Patient Copayment $16.56
  • Minimum Established Patient Copayment $4.13
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1831824804, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
3
Doubled → 6
Pos 4
1
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
2
Unchanged
Pos 7
4
Doubled → 8
Pos 8
8
Unchanged
Pos 9
0
Doubled → 0
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 8 → 16 → 7 4 → 8 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 6 + 1 + 1 + 6 + 2 + 8 + 8 + 0 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1831824804.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
1401 MADISON AVE
COVINGTON, KY 41011
Nurse Practitioner (Pediatrics)
1401 MADISON AVE
COVINGTON, KY 41011
Social Worker (Clinical)
1401 MADISON AVE
COVINGTON, KY 41011
Nurse Practitioner (Family)
1401 MADISON AVE
COVINGTON, KY 41011
Nurse Practitioner (Family)
1401 MADISON AVE
COVINGTON, KY 41011
Nurse Practitioner (Psychiatric/Mental Health)
1401 MADISON AVE
COVINGTON, KY 41011
Dentist (General Practice)
1401 MADISON AVE
COVINGTON, KY 41011
Obstetrics & Gynecology
1401 MADISON AVE
COVINGTON, KY 41011
Dentist
1401 MADISON AVE
COVINGTON, KY 41011
Clinic/Center (Federally Qualified Health Center (FQHC))
1401 MADISON AVE
COVINGTON, KY 41011
Pediatrics
1401 MADISON AVE
COVINGTON, KY 41011
Nurse Practitioner (Family)
1401 MADISON AVE
COVINGTON, KY 41011
Social Worker (Clinical)
1401 MADISON AVE
COVINGTON, KY 41011
Counselor (Professional)
1401 MADISON AVE
COVINGTON, KY 41011
Nurse Practitioner (Family)
1401 MADISON AVE
COVINGTON, KY 41011
Dentist
1401 MADISON AVE
COVINGTON, KY 41011
Pediatrics
1401 MADISON AVE
COVINGTON, KY 41011
Advanced Practice Midwife
1401 MADISON AVE
COVINGTON, KY 41011
Obstetrics & Gynecology
1401 MADISON AVE
COVINGTON, KY 41011
Ophthalmology
1401 MADISON AVE
COVINGTON, KY 41011

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1831824804, enumerated as an "individual" on July 22, 2022.

The provider is located at 1401 MADISON AVE COVINGTON, KY 41011 and the phone number is (859) 655-6100.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.