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PRAVINKUMAR BAHECHARDAS PATEL M.D.
NPI 1962631242
Internal Medicine in West Reading, PA

Active since July 08, 2009PECOS EnrolledAccepts Medicare Assignment
420 S 5TH AVE, WEST READING, PA 19611(484) 628-5455 Get Directions Write a Review

NPPES record last updated: July 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pravinkumar Bahechardas Patel M.d. NPPES

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

PRAVINKUMAR BAHECHARDAS PATEL M.D. (NPI 1962631242) is an individual internal medicine provider in West Reading, Pennsylvania, licensed in Pennsylvania (MD446897) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Morristown Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1962631242
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePRAVINKUMAR BAHECHARDAS PATELCredential: M.D.
Location Address420 S 5TH AVEWest Reading, PA 19611-2143
Mailing Address420 S 5th AveWest Reading, PA 19611-2143
Phone(484) 628-5455
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateJuly 8, 2009
Last NPPES UpdateJuly 27, 2022
NPPES CertifiedJuly 27, 2022
✔ NPI 1962631242 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MD446897
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.
420 S 5TH AVE, West Reading, PA 19611
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Secondary Practice Locations 2

Location 11600 E High StPottstown, PA 19464-5008 · Phone (610) 327-7000
Location 2140 Nutt RdPhoenixville, PA 19460-3906 · Phone (484) 628-5455

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

Pravinkumar Bahechardas Patel M.d. 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 ID3971749680
PECOS Enrollment IDI20130425000465, I20200326000265
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 7

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.
900 services312 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.
177 services168 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.
172 services101 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.
138 services137 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.
83 services83 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.
46 services45 patients

Hospital Affiliations CMS Care Compare 5

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

Morristown Medical Center

Acute Care Hospitals · Morristown, NJ
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310015
Location100 Madison AveMorristown, NJ 07960 · Morris County
Emergency services Birthing friendly

Hackettstown Medical Center

Acute Care Hospitals · Hackettstown, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310115
Location651 Willow Grove StHackettstown, NJ 07840 · Warren County
Emergency services

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390133
Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County
Emergency services Birthing friendly

Lehigh Valley Hospital - Pocono

Acute Care Hospitals · East Stroudsburg, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390201
Location206 East Brown StreetEast Stroudsburg, PA 18301 · Monroe County
Emergency services Birthing friendly

Lehigh Valley Hospital - Dickson City

Acute Care Hospitals · Dickson City, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number390338
Location330 Main StreetDickson City, PA 18519 · Lackawanna County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19611 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%318 patients5/55-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 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
5 suppliers42 claims42 services$15.04 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
5 suppliers44 claims44 services$71.97 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier14 claims14 services$32.06 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.

TOLUWANIMI OGBONMIDE
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
URVASHI SARKAR
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
MADISON HECK
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
NEIL HOFFMAN M.D.
Pathology (Forensic Pathology)
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8615
MS. LANE ROSCOE PA- C
Physician Assistant
420 S 5TH AVE
WEST READING, PA 19611
Berks County (610) 568-3637
ALICE LEE DO
Surgery
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-4879
KYLE ROMPALA
Nurse Practitioner (Family)
420 S 5TH AVE
READING, PA 19611
Berks County (267) 280-7615
MATTHEW CRYER
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-1324

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 Pravinkumar Patel's NPI number?

The NPI number for Pravinkumar Patel is 1962631242. It was assigned to this individual provider in the NPPES registry on July 8, 2009.

Where is Pravinkumar Patel located?

Pravinkumar Patel practices at 420 S 5th Ave, West Reading, PA 19611. The listed phone number is (484) 628-5455.

What is Pravinkumar Patel's specialty?

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

Is Pravinkumar Patel enrolled in Medicare?

Yes. Pravinkumar 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.

Is Pravinkumar Patel affiliated with any hospitals?

According to CMS data, Pravinkumar Patel is affiliated with Morristown Medical Center, Hackettstown Medical Center, Lehigh Valley Hospital, Lehigh Valley Hospital - Pocono and Lehigh Valley Hospital - Dickson City.

When was this NPI record last updated?

The NPPES record for Pravinkumar Patel was last updated on July 27, 2022. 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.