PARTHSARTHI R PATEL, M.D.
NPI 1629171756, individual, Newington, CT, Family Medicine
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PARTHSARTHI R PATEL, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | September 6, 2006, last updated December 12, 2016 |
| Practice location | 2288 BERLIN TPKE, Newington, CT 06111-3206, 860-757-3575 |
| Specialties | Emergency Medicine (207P00000X, license 045268 CT) Family Medicine (207Q00000X, primary, license 045268 CT) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $2.9M | 39% | $109 | $60 (top 5% from $133) | 89th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.7M | 22% | $76 | $44 (top 5% from $110) | 86th percentile | |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | $1.0M | 14% | $55 | $44 (top 5% from $70) | 85th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $868K | 12% | $103 | $67 (top 5% from $121) | 89th percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $319K | 4% | $74 | $45 (top 5% from $138) | 84th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $236K | 3% | $50 | $28 (top 5% from $147) | 80th percentile | |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | $121K | 2% | $22 | $22 (top 5% from $33) | 52nd percentile | |
| 99396 | Medicaid service code | $95K | 1% | $127 | $70 (top 5% from $132) | 92nd percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 549 | 272 | $46K | $192 | $134 | 1.4x | 2.3x (90th percentile 3.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 216 | 133 | $13K | $174 | $95 | 1.8x | 2.2x (90th percentile 3.8x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 113 | 113 | $8K | $199 | $117 | 1.7x | 2.4x (90th percentile 3.9x) |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 51 | 51 | $7K | $215 | $135 | 1.6x | 2.3x (90th percentile 4.1x) |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 46 | 42 | $2K | $75 | $50 | 1.5x | 2.4x (90th percentile 3.7x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 14 | 14 | $2K | $209 | $174 | 1.2x | 2.4x (90th percentile 3.9x) |
| 90662 | Influenza vaccine split virus, preservative free | 21 | 21 | $2K | $81 | $79 | 1.0x | 1.1x (90th percentile 2.1x) |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 60 | 29 | $973 | $45 | $16 | 2.8x | 2.5x (90th percentile 3.9x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
33 providers in Newington, CT carry an indicator in the public record, with $8.2M at stake between them. The most common is named in an enforcement record, on 12 of them, followed by more hours than a day holds on 9. 12 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | SHAWN TYSON Hartford, CT, ranked 62 | $0 |
|
| 1 | MINDS CORNERSTONE LLC Wethersfield, CT, ranked 74 | $721K |
|
| 1 | HELEN ZERVAS Bristol, CT, ranked 112 | $192K |
|
| 1 | SORAYA SAWICKI Avon, CT, ranked 133 | $131K |
|
| 1 | MICHAEL PINES Glastonbury, CT, ranked 444 | $0 |
|
| 1 | THE GEMINI PROJECT, LLC Newington, CT, ranked 446 | $0 |
|
| 1 | COLLABORATIVE COUNSELING CENTER, LLC Hartford, CT, ranked 550 | $0 |
|
| 1 | DONALD SALZBERG West Hartford, CT, ranked 575 | $0 |
|
Recent enforcement in CT
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.