DR. KALPESH PRAGJI BHESANIYA MD
NPI 1922318179
Family Medicine in Victoria, TX

Q: What is Kalpesh Bhesaniya's NPI number?

The NPI number for Kalpesh Bhesaniya is 1922318179. It was assigned to this individual provider in the NPPES registry on October 20, 2010.

Q: What is Kalpesh Bhesaniya's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kalpesh Bhesaniya was last updated on September 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 October 20, 2010PECOS EnrolledAccepts Medicare Assignment

86.37/100

CMS Quality Rating

506 E SAN ANTONIO ST, VICTORIA, TX 77901(361) 579-6500(361) 788-6655 Get Directions Write a Review

NPPES record last updated: September 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 7, 2023, Sep 6, 2022, Apr 11, 2018 (3 updates tracked since 2018).

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About Dr. Kalpesh Pragji Bhesaniya Md NPPES

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

DR. KALPESH PRAGJI BHESANIYA MD (NPI 1922318179) is an individual family medicine provider in Victoria, Texas, licensed in Texas (P9162) and active in the NPI registry since October 2010. He is enrolled in Medicare PECOS, is affiliated with Citizens Medical Center, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1922318179

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KALPESH PRAGJI BHESANIYACredential: MD

Location Address506 E SAN ANTONIO STVictoria, TX 77901-6060

Mailing Address506 E San Antonio StVictoria, TX 77901-6060 · (361) 579-6500 · Fax (361) 788-6655

Phone(361) 579-6500

Fax(361) 788-6655

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateOctober 20, 2010

Last NPPES UpdateSeptember 7, 20233 updates tracked since enumeration

NPPES CertifiedSeptember 7, 2023

✔ NPI 1922318179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · P9162

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X · License P9162 (TX)

506 E SAN ANTONIO ST, Victoria, TX 77901

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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

Dr. Kalpesh Pragji Bhesaniya 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 ID9335384346

PECOS Enrollment IDI20150129001397

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 8

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.

1,637 services311 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.

362 services66 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.

264 services231 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

263 services232 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.

153 services77 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.

66 services63 patients

Hospital Affiliations CMS Care Compare 4

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

Citizens Medical Center

Acute Care Hospitals · Victoria, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number450023

Location2701 Hospital DriveVictoria, TX 77901 · Victoria County

Emergency services Birthing friendly

De Tar Hospital Navarro

Acute Care Hospitals · Victoria, TX

4/5 CMS rating

OwnershipProprietary

CMS Certification Number450147

Location506 E San Antonio StVictoria, TX 77901 · Victoria County

Emergency services Birthing friendly

Cuero Regional Hospital

Acute Care Hospitals · Cuero, TX

OwnershipGovernment - Hospital District or Authority

CMS Certification Number450597

Location2550 N EsplanadeCuero, TX 77954 · De Witt County

Emergency services Birthing friendly

Jackson Healthcare Center

Critical Access Hospitals · Edna, TX

OwnershipGovernment - Hospital District or Authority

CMS Certification Number451363

Location1013 S WellsEdna, TX 77957 · Jackson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77901 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

86.37/100

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

Scored through an Alternative Payment Model

Quality

72.75

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier34 claims34 services$19.52 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

1 supplier39 claims39 services$111.71 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier11 claims12 services$23.81 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

VICTORIA OF TEXAS LP

General Acute Care Hospital (Critical Access)