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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KETUL PATEL DO
NPI 1861075293
Internal Medicine - Cardiovascular Disease in Wilkes Barre, PA

Active since May 03, 2021PECOS Enrolled
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711(570) 808-7399(570) 808-5942 Get Directions Write a Review

NPPES record last updated: October 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 13, 2026, May 10, 2021, May 3, 2021 (3 updates tracked since 2021).

About Ketul Patel Do NPPES

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

KETUL PATEL DO (NPI 1861075293) is an individual cardiovascular disease provider in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (OS023465) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2021).

NPPES Registry Identity

NPI1861075293
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameKETUL PATELCredential: DO
Location Address1000 E MOUNTAIN DRWilkes Barre, PA 18711-0027
Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 808-7399 · Fax (570) 808-5942
Phone(570) 808-7399
Fax(570) 808-5942
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2021
Enumeration DateMay 3, 2021
Last NPPES UpdateOctober 13, 20263 updates tracked since enumeration
NPPES CertifiedOctober 13, 2026
✔ NPI 1861075293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in PA · OS023465
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
1000 E MOUNTAIN DR, Wilkes Barre, PA 18711
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ketul Patel Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1759824246
PECOS Enrollment IDI20251112004086
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 Reassignment

Medicare enrollment records show Ketul Patel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Geisinger Clinic
0.2 mi
Hematology & Oncology
1000 E MOUNTAIN DR
Wilkes Barre, PA 18711
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 4,429 clinicians in this Medicare group
NPI 1316999782 (570) 826-7300

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18711 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

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.

DR. PAUL ANTHONY ARKLESS M.D.
Internal Medicine (Pulmonary Disease)
1000 E MOUNTAIN DR, PULMONARY DEPARTMENT
WILKES BARRE, PA 18711
Luzerne County (570) 808-5770
DR. JEEWENDRA DULAL M.D.
Hospitalist
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Luzerne County (570) 808-7399
DR. DANIEL GOLTZ D.O
Emergency Medicine
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Luzerne County (570) 808-7762
JULIA CHRISTINA D'SOUZA MD MTR
Radiology (Vascular & Interventional Radiology)
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Luzerne County (570) 808-7779
VRUNDA MANGAROLIYA MD
Hospitalist
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Luzerne County (570) 808-7399
BARRY LEE GREEN DO
Obstetrics & Gynecology
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Luzerne County (570) 808-7916
HALEEMA SAJID M.D.
Obstetrics & Gynecology
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Luzerne County (570) 808-7916
MEENAKSHI DAVULURI M.D.
Urology
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Luzerne County (570) 808-7850

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 Ketul Patel's NPI number?

The NPI number for Ketul Patel is 1861075293. It was assigned to this individual provider in the NPPES registry on May 3, 2021.

Where is Ketul Patel located?

Ketul Patel practices at 1000 E Mountain Dr, Wilkes Barre, PA 18711. The listed phone number is (570) 808-7399.

What is Ketul Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Ketul Patel enrolled in Medicare?

Yes. Ketul Patel is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ketul Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ketul Patel reassigns Medicare benefits to Geisinger Clinic (Wilkes Barre, PA). The 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 Ketul Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ketul Patel accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Ketul 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 Ketul Patel was last updated on October 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days 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.