NIRAL PATEL MD
NPI 1912923079
Internal Medicine in Windermere, FL

Q: What is Niral Patel's NPI number?

The NPI number for Niral Patel is 1912923079. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Q: What is Niral Patel'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 Niral Patel was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since July 14, 2006PECOS EnrolledAccepts Medicare Assignment

85.38/100

CMS Quality Rating

11600 LAKESIDE VILLAGE LANE, WINDERMERE, FL 34786(407) 876-2273(407) 347-3950 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 3, 2020, Sep 18, 2020 (2 updates tracked since 2020).

On this page

About Niral Patel Md NPPES

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

NIRAL PATEL MD (NPI 1912923079) is an individual internal medicine provider in Windermere, Florida, licensed in Florida (ME106053) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Orlando Health, and maintains a secondary practice location in Windermere.

NPPES Registry Identity

NPI1912923079

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameNIRAL PATELCredential: MD

Location Address11600 LAKESIDE VILLAGE LANEWindermere, FL 34786

Mailing Address3300 S Fiske BlvdRockledge, FL 32955-4306 · (407) 876-2273 · Fax (407) 347-3950

Phone(407) 876-2273

Fax(407) 347-3950

Sole ProprietorYes

Medical School CMSOtherGraduated 2002

Enumeration DateJuly 14, 2006

Last NPPES UpdateNovember 3, 20202 updates tracked since enumeration

NPPES CertifiedNovember 3, 2020

✔ NPI 1912923079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in FL · ME106053✔ Licensed in IL · 036-115718

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.

11600 LAKESIDE VILLAGE LANE, Windermere, FL 34786

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Secondary Practice Location 1

Location 111600 Lakeside Village LnWindermere, FL 34786-7024 · Phone (407) 876-2273 · Fax (407) 347-3950

Other Identifiers 4

OtherM7254FL · Fl Hf Medicare

Medicaid036115718IL

OtherME106053FL · Florida License

Other036-115718IL · State License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama 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

Niral Patel 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 ID6608870506

PECOS Enrollment IDI20101012001145

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 Niral Patel reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Central Florida Hospitalist Partners PA

12 mi

Hospitalist

1414 KUHL AVE
Orlando, FL 32806

Reassigned Medicare billing, Florida enrollment
191 clinicians in this Medicare group

NPI 1558381921 (407) 464-9516

Privia Medical Group Florida, LLC

65 mi

General Practice

140 6TH AVE
Indialantic, FL 32903

Reassigned Medicare billing, Florida enrollment
Medicare enrollment name: Health First Privia Medical Group
329 clinicians in this Medicare group

NPI 1700649043 (321) 312-3501

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 23

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.

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.

561 services280 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.

486 services259 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

235 services235 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

170 services25 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

155 services75 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

149 services149 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

136 services59 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

110 services91 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

84 services79 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

82 services77 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

75 services60 patients

Inhalation treatment for airway obstruction or sputum production 94640

Inhalation treatment, also known as nebulizer therapy, helps clear airway obstructions and reduce sputum production. It involves breathing in medication through a device, turning it into a mist. This can open up the airways, making breathing easier and helping to cough out mucus.

44 services23 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

44 services11 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.

40 services40 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.

28 services27 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

27 services22 patients

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

Budesonide is a medication administered via inhalation to control and prevent symptoms like wheezing and shortness of breath caused by asthma. This FDA-approved solution is non-compounded and administered through a device (DME). Each unit dose contains up to 0.5 mg.

24 services23 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

22 services21 patients

Injection, orphenadrine citrate, up to 60 mg J2360

Orphenadrine citrate is a muscle relaxant used to treat muscle spasms and pain. In this procedure, up to 60 mg of the drug is injected into the body, helping to reduce discomfort and improve mobility.

20 services18 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.

19 services19 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

19 services19 patients

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

Albuterol is a medication used to treat breathing problems. It is administered as an inhalation solution through a device called DME (Durable Medical Equipment). The solution is FDA-approved and non-compounded. Each unit dose contains 1 mg of the medicine.

18 services13 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Orlando Health

Acute Care Hospitals · Orlando, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100006

Location52 W Underwood StOrlando, FL 32806 · Orange County

Emergency services Birthing friendly

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100007

Location601 E Rollins StOrlando, FL 32803 · Orange County

Emergency services Birthing friendly

Orlando Health-Health Central Hospital

Acute Care Hospitals · Ocoee, FL

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number100030

Location10000 W Colonial DrOcoee, FL 34761 · Orange County

Emergency services

Orlando Health South Lake Hospital

Acute Care Hospitals · Clermont, FL

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100051

Location1900 Don Wickham DrClermont, FL 34711 · Lake County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34786 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

85.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

81.65

Promoting Interoperability

Improvement Activities

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.

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers16 claims16 services$10.65 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers16 claims85 services$1.81 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers22 claims25 services$33.13 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

2 suppliers11 claims330 services$0.79 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers19 claims19 services$185.51 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 Niral Patel's NPI number?

The NPI number for Niral Patel is 1912923079. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Where is Niral Patel located?

Niral Patel practices at 11600 Lakeside Village Lane, Windermere, FL 34786. The listed phone number is (407) 876-2273.

What is Niral Patel's specialty?

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

Is Niral Patel enrolled in Medicare?

Yes. Niral 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 Niral Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Niral Patel reassigns Medicare benefits to 2 organizations: Central Florida Hospitalist Partners PA (Orlando, FL) and Privia Medical Group Florida, LLC (Indialantic, 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 Niral Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Niral Patel accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Cigna HealthCare of Florida, Inc. and Cigna Healthcare and 4 other insurers list Niral 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 Niral Patel affiliated with any hospitals?

According to CMS data, Niral Patel is affiliated with Orlando Health, Adventhealth Orlando, Orlando Health-Health Central Hospital and Orlando Health South Lake Hospital.

When was this NPI record last updated?

The NPPES record for Niral Patel was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.