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PAYAL PATEL MD
NPI 1912140781
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in New York, NY

Active since April 09, 2009PECOS Enrolled
87.52/100
CMS Quality Rating
436 3RD AVE STE LL, NEW YORK, NY 10016(646) 443-6061 Get Directions Write a Review

NPPES record last updated: November 2, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 2, 2021, Sep 2, 2020, Sep 16, 2019 and 1 more (4 updates tracked since 2017).

About Payal Patel Md NPPES

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

PAYAL PATEL MD (NPI 1912140781) is an individual ophthalmic plastic and reconstructive surgery provider in New York, New York, licensed in New York (256484) and active in the NPI registry since April 2009. She is enrolled in Medicare PECOS, is affiliated with Nyu Langone Hospitals, and is a graduate of New York Medical College (2008).

NPPES Registry Identity

NPI1912140781
Entity TypeIndividualFemale
Primary Taxonomy207WX0200X
Provider Legal NamePAYAL PATELCredential: MD
Location Address436 3RD AVE STE LLNew York, NY 10016
Mailing Address436 3rd Ave Ste LlNew York, NY 10016-6025 · (646) 443-6061 · Fax (855) 600-2703
Phone(646) 443-6061
Sole ProprietorNo
Medical School CMSNew York Medical CollegeGraduated 2008
Enumeration DateApril 9, 2009
Last NPPES UpdateNovember 2, 20214 updates tracked since enumeration
NPPES CertifiedNovember 2, 2021
✔ NPI 1912140781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Ophthalmic Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207WX0200X
License✔ Licensed in NY · 256484
Definition
A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.
Also ListedOphthalmologyTaxonomy 207W00000X · License 256484 (NY)
436 3RD AVE STE LL, New York, NY 10016
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana 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 (PECOS)

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

PECOS PAC ID7911163159
PECOS Enrollment IDI20120716000566
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

5

Medicare enrollment records show Payal Patel reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

State Of New York Comptrollers Office
0.8 mi
Optometrist
33 WEST 42ND STREET, CLINICAL ADMINISTRATION
New York, NY 10036
  • Reassigned Medicare billing, New York enrollment
  • 216 clinicians in this Medicare group
NPI 1407829856 (212) 938-4030
Vision Nyc Jonathan Kruh MD PLLC
1.1 mi
Ophthalmology
25 5TH AVE, SUITE 1B
New York, NY 10003
  • Reassigned Medicare billing, New York enrollment
  • 8 clinicians in this Medicare group
NPI 1245602143 (646) 799-3648
Tjh Medical Services, P.C.
9.0 mi
Internal Medicine
8906 135TH ST
Jamaica, NY 11418
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Tjh Medical Services PC
  • 497 clinicians in this Medicare group
NPI 1184670465 (718) 206-6742
Omni Eye Specialists P A
22 mi
Ophthalmology
485 ROUTE 1 SOUTH, BLDG A
Iselin, NJ 08830
  • Reassigned Medicare billing, New Jersey enrollment
  • 61 clinicians in this Medicare group
NPI 1376593863 (732) 750-0400
New York University
1,039 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 2,450 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

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 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.

Photography of content of eyes 92285
Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.
67 services62 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.
40 services34 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.
34 services34 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.
34 services34 patients
Removal of growth of eyelid 67840
The removal of an eyelid growth is a procedure performed to eliminate abnormal tissue from your eyelid. It's generally a quick, outpatient treatment. The doctor numbs your eyelid, carefully removes the growth, and may stitch the area if necessary. This can help maintain eye health and vision.
27 services21 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.
21 services19 patients

Hospital Affiliations CMS Care Compare

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

Nyu Langone Hospitals

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330214
Location550 First AvenueNew York, NY 10016 · New York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10016 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
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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.

87.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability92
Improvement Activities40
Cost60.88

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 Payal Patel's NPI number?

The NPI number for Payal Patel is 1912140781. It was assigned to this individual provider in the NPPES registry on April 9, 2009.

Where is Payal Patel located?

Payal Patel practices at 436 3rd Ave Ste Ll, New York, NY 10016. The listed phone number is (646) 443-6061.

What is Payal Patel's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Ophthalmic Plastic and Reconstructive Surgery, with taxonomy code 207WX0200X.

Is Payal Patel enrolled in Medicare?

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

Which organizations bill Medicare for Payal Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Payal Patel reassigns Medicare benefits to 5 organizations: State Of New York Comptrollers Office (New York, NY), Vision Nyc Jonathan Kruh MD PLLC (New York, NY), Tjh Medical Services, P.C. (Jamaica, NY), Omni Eye Specialists P A (Iselin, NJ) and New York University (Boynton Beach, FL). 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 Payal Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Payal Patel accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 2 other insurers list Payal 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 Payal Patel affiliated with any hospitals?

According to CMS data, Payal Patel is affiliated with Nyu Langone Hospitals.

When was this NPI record last updated?

The NPPES record for Payal Patel was last updated on November 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.