Medicare billing address
CMS Medicare provider billing file
1591 Medical DrPottstown, PA 19464
CMS public data · NPI 1043290372
Dr. Nainesh M Patel: Medicare prescribing and billing data
CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.
CMS display name
Nainesh M Patel, MD
Specialty
Credential
MD
NPI
1043290372
Primary source state
PA
Data retrieval date
July 26, 2026
What related Medicare data is on this site?
Pennsylvania doctorsState Doctor hubCardiologyState-specialty hubPottstown, PAPrimary city link if this route exists
Where these numbers come from, and what they cannot tell you
Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.
How should you read this Doctor page?
This page shows Medicare billing and Part D prescribing data for Nainesh M Patel, MD from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.
A licensed agent, not a call center
Do your doctors and prescriptions fit before you enroll?
Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.
What Medicare source indicators are listed for this NPI?
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
Which practice locations appear in CMS files?
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
Pottstown, PA 19464
PHOENIXVILLE CLINIC COMPANY LLC
CMS Doctors & Clinicians file
824 Main StSuite 306
Phoenixville, PA 19460
What does the Medicare billing file show?
In the 2024 CMS provider billing file, this NPI had 2,411 Medicare beneficiaries and 4,779 total services. The average beneficiary age was 76, and the average HCC risk score was 1.7.
Total Medicare allowed amount
$299,809.95
Total Medicare payment amount
$221,096.19
Medicare beneficiaries
2,411
Total services
4,779
Which patient-panel condition fields does CMS report?
These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.
Hyperlipidemia
75%
CMS beneficiary-panel share
Hypertension
75%
CMS beneficiary-panel share
Ischemic heart disease
47%
CMS beneficiary-panel share
Chronic kidney disease
39%
CMS beneficiary-panel share
Atrial fibrillation
38%
CMS beneficiary-panel share
Diabetes
34%
CMS beneficiary-panel share
Where these service numbers come from, and what they cannot tell you
Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.
Which Medicare services appear most often?
| CMS service description | Services | Avg allowed |
|---|---|---|
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 1,193 | $8.12 |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 822 | $131.30 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 818 | $14.70 |
| Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 506 | $68.24 |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 189 | $174.27 |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 150 | $119.21 |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 124 | $79.45 |
| Programming of dual lead pacemaker system | 120 | $80.04 |
| Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician | 105 | $20.95 |
| Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician | 105 | $13.86 |
Where these Part D numbers come from, and what they cannot tell you
CMS data reports historical prescription drug events attributed to NPI 1043290372. Formularies, copays, prior authorization, and step therapy rules vary by current coverage.
Which drugs did Nainesh M Patel, MD prescribe most often under Medicare Part D?
| Rank | Drug | Generic name | Total claims | 30-day fills | Total drug cost |
|---|---|---|---|---|---|
| 1 | Metoprolol Succinate | Metoprolol Succinate | 782 | 2,124.5 | $14,202.76 |
| 2 | Eliquis | Apixaban | 732 | 1,349.5 | $764,321.41 |
| 3 | Atorvastatin Calcium | Atorvastatin Calcium | 617 | 1,732 | $6,342.74 |
| 4 | Losartan Potassium | Losartan Potassium | 414 | 1,051.9 | $4,625.57 |
| 5 | Amlodipine Besylate | Amlodipine Besylate | 362 | 994.5 | $2,403.30 |
| 6 | Furosemide | Furosemide | 348 | 820.9 | $1,540.95 |
| 7 | Lisinopril | Lisinopril | 324 | 860.1 | $2,195.70 |
| 8 | Rosuvastatin Calcium | Rosuvastatin Calcium | 241 | 615 | $3,995.93 |
| 9 | Carvedilol | Carvedilol | 224 | 550.2 | $1,809.26 |
| 10 | Metoprolol Tartrate | Metoprolol Tartrate | 222 | 585.5 | $1,674.58 |
CMS Part D records are historical aggregate claims data. They do not include current formulary status, pharmacy price, prior-authorization rules, network-directory status, or clinical-outcome data.
What background fields does CMS report?
Graduation year
1982
Group/practice field
Phoenixville Clinic Company Llc
Telehealth reported
Not reported
Secondary specialty fields reported by CMS: Internal Medicine.
What can this data not tell us?
- Billing data and prescribing data come from different CMS files. Neither one measures clinical outcomes, and neither one tells you whether this doctor is in a specific plan's network.
- Part D records do not report current medication use, plan coverage, price, pharmacy availability, or plan-directory status.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.
- CMS billing data does not list Medicare Advantage plan-directory status for this doctor.
- CMS service and prescribing records are historical public-use aggregates; they do not report current appointment availability, clinical outcomes, or patient-specific medical advice.
- Part D provider-and-drug records do not include current formulary status, copay amount, pharmacy price, prior-authorization rules, or step-therapy rules.
What should you verify separately?
Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.
Which CMS sources support this page?
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.
- Medicare Physician & Other Practitioners - by Provider · 1 records for this NPI · retrieved July 26, 2026
- Medicare Physician & Other Practitioners - by Provider and Service · 23 records for this NPI · retrieved July 26, 2026
- Doctors and Clinicians National Downloadable File · 1 records for this NPI · retrieved July 26, 2026
- Opt-Out Affidavits · 0 records for this NPI · retrieved July 26, 2026
- Medicare Part D Prescribers - by Provider and Drug · 65 records for this NPI · retrieved July 26, 2026
What caveats apply to this page?
- CMS billing and utilization files do not list Medicare Advantage plan networks, appointment availability, or clinical outcomes.
- Part D provider-and-drug files are historical aggregate claims data; they do not report current medication lists, plan coverage, pharmacy price, or prior-authorization rules.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.