NIRAL PATEL MD
NPI 1912923079
Internal Medicine in Windermere, FL

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: August 02, 2026.

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

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
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

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

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
Quality81.65
Promoting Interoperability78
Improvement Activities40

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.

What insurance does Niral Patel accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer 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.