DR. HEMANTKUMAR G PATEL MD
NPI 1932178357
Internal Medicine - Pulmonary Disease in Newark, NJ

Q: What is Hemantkumar Patel's NPI number?

The NPI number for Hemantkumar Patel is 1932178357. It was assigned to this individual provider in the NPPES registry on March 16, 2006.

Q: What is Hemantkumar Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Hemantkumar Patel was last updated on September 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 March 16, 2006PECOS EnrolledAccepts Medicare Assignment

646 SANFORD AVE, NEWARK, NJ 07106(973) 373-7700(973) 373-8177 Get Directions Write a Review

NPPES record last updated: September 10, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Hemantkumar G Patel Md NPPES

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

DR. HEMANTKUMAR G PATEL MD (NPI 1932178357) is an individual pulmonary disease provider in Newark, New Jersey, licensed in New Jersey (MA043021) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Newark Beth Israel Medical Center, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1932178357

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. HEMANTKUMAR G PATELCredential: MD

Location Address646 SANFORD AVENewark, NJ 07106-3036

Mailing AddressPo Box 290Vauxhall, NJ 07088-0290 · (973) 373-7700 · Fax (973) 373-8177

Phone(973) 373-7700

Fax(973) 373-8177

Sole ProprietorYes

Medical School CMSOtherGraduated 1982

Enumeration DateMarch 16, 2006

Last NPPES UpdateSeptember 10, 2014

✔ NPI 1932178357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in NJ · MA043021

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

646 SANFORD AVE, Newark, NJ 07106

Open in Google Maps ↗

Other Identifiers 3

Medicaid3830501NJ

Medicare UPINE13126NJ

Medicare OSCAR/certification092509NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Dr. Hemantkumar G 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 ID2062492085

PECOS Enrollment IDI20101227000847

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 Reassignment

Medicare enrollment records show Hemantkumar Patel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hemant G Patel MD PA

Same address

Specialist

646 SANFORD AVE
Newark, NJ 07106

Reassigned Medicare billing, New Jersey enrollment
3 clinicians in this Medicare group

NPI 1841245081 (973) 373-7700

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 13

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.

3,006 services377 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.

1,984 services260 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.

450 services361 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

342 services285 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.

152 services73 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

136 services68 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.

109 services60 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

106 services20 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

98 services18 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

46 services43 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.

33 services31 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

17 services15 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.

16 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Newark Beth Israel Medical Center

Acute Care Hospitals · Newark, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310002

Location201 Lyons AveNewark, NJ 07112 · Essex County

Emergency services Birthing friendly

Cooperman Barnabas Medical Center

Acute Care Hospitals · Livingston, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310076

Location94 Old Short Hills RoadLivingston, NJ 07039 · Essex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07106 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

100%12,181 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

14%2,446 patients1/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

1%2,446 patients1/55-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 21

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers12 claims25 services$5.03 avg. paid by Medicare

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314

DME-Orthotic Devices · category DF000N

2 suppliers14 claims14 services$19.58 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

2 suppliers14 claims14 services$7.71 avg. paid by Medicare

Tape, non-waterproof, per 18 square inches A4450

DME-Medical/Surgical Supplies · category DA000N

2 suppliers11 claims764 services$0.09 avg. paid by Medicare

Tracheostomy, inner cannula A4623

DME-Orthotic Devices · category DF000N

1 supplier29 claims870 services$6.32 avg. paid by Medicare

Tracheostomy care kit for established tracheostomy A4629

DME-Orthotic Devices · category DF000N

2 suppliers40 claims1,211 services$4.26 avg. paid by Medicare

Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing A6220

DME-Medical/Surgical Supplies · category DA023N

2 suppliers12 claims384 services$2.36 avg. paid by Medicare

Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446

DME-Medical/Surgical Supplies · category DA023N

2 suppliers11 claims1,968 services$0.33 avg. paid by Medicare

Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each A7521

DME-Orthotic Devices · category DF000N

2 suppliers13 claims13 services$45.33 avg. paid by Medicare

Tracheostomy tube collar/holder, each A7526

DME-Orthotic Devices · category DF000N

2 suppliers34 claims410 services$3.27 avg. paid by Medicare

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

3 suppliers13 claims316 services$2.62 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

2 suppliers86 claims1,752 services$4.26 avg. paid by Medicare

Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150

Other-Enteral and Parenteral · category OB006N

1 supplier13 claims3,728 services$0.32 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

4 suppliers81 claims26,688 services$0.27 avg. paid by Medicare

Enteral nutrition infusion pump, any type B9002

Other-Enteral and Parenteral · category OB005N

2 suppliers43 claims43 services$50.87 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

2 suppliers18 claims18 services$40.64 avg. paid by Medicare

Iv pole E0776

DME-Other DME · category DE000N

1 supplier52 claims52 services$4.18 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

3 suppliers18 claims19 services$62.26 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

4 suppliers17 claims1,716 services$0.09 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$12.99 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

2 suppliers16 claims16 services$4.33 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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DENIS SCHISANO MD

Internal Medicine (Cardiovascular Disease)

646 SANFORD AVE
NEWARK, NJ 07106

Essex County (973) 373-7700

HEMANT G PATEL MD PA

Specialist

646 SANFORD AVE
NEWARK, NJ 07106

Essex County (973) 373-7700

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 Hemantkumar Patel's NPI number?

The NPI number for Hemantkumar Patel is 1932178357. It was assigned to this individual provider in the NPPES registry on March 16, 2006.

Where is Hemantkumar Patel located?

Hemantkumar Patel practices at 646 Sanford Ave, Newark, NJ 07106. The listed phone number is (973) 373-7700.

What is Hemantkumar Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Hemantkumar Patel enrolled in Medicare?

Yes. Hemantkumar 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 organization bills Medicare for Hemantkumar Patel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hemantkumar Patel reassigns Medicare benefits to Hemant G Patel MD PA (Newark, NJ). The 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 Hemantkumar Patel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hemantkumar Patel accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Hemantkumar 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 Hemantkumar Patel affiliated with any hospitals?

According to CMS data, Hemantkumar Patel is affiliated with Newark Beth Israel Medical Center and Cooperman Barnabas Medical Center.

When was this NPI record last updated?

The NPPES record for Hemantkumar Patel was last updated on September 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.