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NIHAR HASMUKH PATEL DO
NPI 1861416281
Internal Medicine in Mt Pleasant, SC

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment
0/100
CMS Quality Rating
973 HOUSTON NORTHCUTT BLVD, MT PLEASANT, SC 29464(606) 434-9669 Get Directions Write a Review

NPPES record last updated: January 31, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 31, 2026, Jun 4, 2025 (2 updates tracked since 2025).

About Nihar Hasmukh Patel Do NPPES

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

NIHAR HASMUKH PATEL DO (NPI 1861416281) is an individual internal medicine provider in Mt Pleasant, South Carolina, licensed in South Carolina (1001) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1861416281
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameNIHAR HASMUKH PATELCredential: DO
Location Address973 HOUSTON NORTHCUTT BLVDMt Pleasant, SC 29464-5656
Mailing Address625 Carolina BlvdIsle Of Palms, SC 29451-2116
Phone(606) 434-9669
Sole ProprietorYes
Medical School CMSUniversity Of Pikeville, Kentucky College Of Osteopathic MedGraduated 1999
Enumeration DateJuly 27, 2006
Last NPPES UpdateJanuary 31, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 31, 2026
✔ NPI 1861416281 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in SC · 1001✔ Licensed in OH · 34008521
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.
973 HOUSTON NORTHCUTT BLVD, Mt Pleasant, SC 29464
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Secondary Practice Locations 2

Location 1316 Calhoun StCharleston, SC 29401-1113 · Phone (843) 724-2450 · Fax (843) 724-2455
Location 29181 Medcom StNorth Charleston, SC 29406-9168 · Phone (843) 820-7777

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next.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

Nihar Hasmukh Patel Do 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 ID2668479346
PECOS Enrollment IDI20061024000062
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

4

Medicare enrollment records show Nihar Patel reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Roper Saint Francis Physicians Network
0.6 mi
Urology
180 WINGO WAY, SUITE 304
Mt Pleasant, SC 29464
  • Reassigned Medicare billing, South Carolina enrollment
  • 658 clinicians in this Medicare group
NPI 1184924227 (843) 884-8045
24 On Physicians Of Sc, LLC
3.6 mi
Hospitalist
316 CALHOUN ST
Charleston, SC 29401
  • Reassigned Medicare billing, South Carolina enrollment
  • 281 clinicians in this Medicare group
NPI 1144877655 (800) 923-2247
Pinnacle Physicians, LLC
16 mi
Internal Medicine
9181 MEDCOM ST
North Charleston, SC 29406
  • Reassigned Medicare billing, South Carolina enrollment
  • 14 clinicians in this Medicare group
NPI 1437455011 (843) 820-7777
Roper St. Francis Specialty Physicians
17 mi
Surgery
8536 PALMETTO COMMERCE PKWY STE 501
Ladson, SC 29456
  • Reassigned Medicare billing, South Carolina enrollment
  • 296 clinicians in this Medicare group
NPI 1528945912 (843) 203-2260

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 7

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.
1,755 services312 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.
220 services214 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
169 services165 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
111 services111 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.
100 services59 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.
37 services36 patients

Hospital Affiliations CMS Care Compare 4

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

Musc Medical Center

Acute Care Hospitals · Charleston, SC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number420004
Location169 Ashley AveCharleston, SC 29425 · Charleston County
Emergency services Birthing friendly

Bon Secours-St Francis Xavier Hospital

Acute Care Hospitals · Charleston, SC
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420065
Location2095 Henry Tecklenburg DriveCharleston, SC 29414 · Charleston County
Emergency services Birthing friendly

Roper Hospital

Acute Care Hospitals · Charleston, SC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420087
Location316 Calhoun StCharleston, SC 29401 · Charleston County
Emergency services

Mount Pleasant Hospital

Acute Care Hospitals · Mount Pleasant, SC
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420104
Location3510 Highway 17 North Suite 140Mount Pleasant, SC 29466 · Charleston County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29464 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
$124.04 typical visit price
range $53.57 – $163.84
Typical copayment $31.01 (range $13.39 – $40.96)
Most-billed visit code 99204
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
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.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%31 patients5/55-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.

Referred Medical Equipment & Supplies CMS DME claims 11

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

Commode chair, mobile or stationary, with detachable arms E0165
DME-Other DME · category DE000N
3 suppliers26 claims26 services$10.16 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
3 suppliers16 claims16 services$51.61 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
2 suppliers32 claims32 services$777.36 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
6 suppliers75 claims75 services$4.55 avg. paid by Medicare
Manual wheelchair accessory, anti-tipping device, each E0971
DME-Wheelchairs · category DD021N
4 suppliers14 claims25 services$26.65 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
8 suppliers195 claims195 services$65.11 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Nihar Patel's NPI number?

The NPI number for Nihar Patel is 1861416281. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Nihar Patel located?

Nihar Patel practices at 973 Houston Northcutt Blvd, Mt Pleasant, SC 29464. The listed phone number is (606) 434-9669.

What is Nihar Patel's specialty?

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

Is Nihar Patel enrolled in Medicare?

Yes. Nihar 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.

Which organizations bill Medicare for Nihar Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nihar Patel reassigns Medicare benefits to 4 organizations: Roper Saint Francis Physicians Network (Mt Pleasant, SC), 24 On Physicians Of Sc, LLC (Charleston, SC), Pinnacle Physicians, LLC (North Charleston, SC) and Roper St. Francis Specialty Physicians (Ladson, SC). 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 Nihar Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nihar Patel accept?

Health plans from First Choice Next list Nihar 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.

Is Nihar Patel affiliated with any hospitals?

According to CMS data, Nihar Patel is affiliated with Musc Medical Center, Bon Secours-St Francis Xavier Hospital, Roper Hospital and Mount Pleasant Hospital.

When was this NPI record last updated?

The NPPES record for Nihar Patel was last updated on January 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.