NPI registry status
Active
2026 NPPES data Ophthalmology Physician NPI 1215959622 M.D.
Verify on CMS → Hitesh Patel, M.D.
Ophthalmology Physician in Edison, New Jersey.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 22,082 in Ophthalmology Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
6K
Medicare Part D claims · 850 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
60%
generic claims · 40% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
85.6/100
▲ 2 pts above national avg 83.5 · Above neutral
Industry payments
$581.97
24 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
What the federal data shows
Hitesh Patel, M.D. reported a CMS MIPS final score of 85.6/100 - above the 83.5 national average - and filed 5,893 Medicare Part D claims in 2023.
- 85.6/100
- MIPS score · +2 vs avg
- 6K
- Part D claims, 2023
- 60%
- generic prescribing
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Hitesh Patel, M.D.'s MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
86 ≥ 46th percentile 46% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Hitesh Patel, M.D. sits
This provider among ophthalmology physician peers
Across the 8,767 ophthalmology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Hitesh Patel, M.D. writes more Part D claims than 97% of them and scores higher on MIPS quality than 40% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one ophthalmology physician peer from a representative sample of 60; the gold marker is Hitesh Patel, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Hitesh Patel, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Hitesh Patel, M.D.?
High performer (top quartile)Primary specialty
Ophthalmology Physician
Medicare Part D claims
5,893 315% vs specialty avg
MIPS final score
85.6/100 2.1 pts vs avg
Specialty distribution in New Jersey
How Ophthalmology Physician compares to other specialties among New Jersey providers
Medicare quality performance, MIPS
Hitesh Patel, M.D.'s 2023 MIPS final score plotted against the Ophthalmology Physician national average
- MIPS Final Score
- 85.6/100
- vs 83.5 national avg · 2023 performance year
MIPS final score (Ophthalmology Physician) - 85.6/100 vs national avg 83.5
How MIPS and board certification work
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Hitesh Patel, M.D. appears in the CMS NPPES registry as an Ophthalmology Physician provider holding M.D. credentials at 228 PLAINFIELD AVE, Edison, NJ, 08817, with a listed phone of (732) 985-5009. NPI 1215959622 was issued on 07/24/2006.
Medicare Part D records for calendar year 2023 show 5,893 prescription claims written by this provider, covering 850 Medicare beneficiaries and totaling roughly $1.3 million in drug spend, split 40% brand-name and 60% generic by claim count. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 85.6/100 for the 2023 performance year (Quality 100, Cost 35.3), compared with the 83.5 average among clinicians with a measured score.
Ophthalmology Physician is a mid-sized specialty nationwide, with 22,082 enrolled providers across 56 states and an average of 1,420 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline.
Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1215959622 |
|---|---|
| Specialty | Ophthalmology Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 07/24/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
85.6011
Final Score
Measured-score avg: 83.5
100
Quality
35.337
Cost
Reporting: Individual
Hospital and facility affiliations
Facilities where Hitesh Patel, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Patel Eye Associates LLC
Edison, NJ
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Hitesh Patel, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$582
Largest payer
Johnson & Johnson Surgical Vision, Inc.
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
Brand vs generic prescribing mix · Above average
Hitesh Patel, M.D. - brand share 40.0%
Ophthalmology Physician average
40% brand-name claims vs 60% generic, on 5,893 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
5,893
Total Claims
$1.3M
Total Drug Cost
850
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 8,944
- Total Day Supply
- 248,084
- Brand vs Generic
- 40% brand / 60% generic
- Brand Drug Cost
- $1.2M
- Generic Drug Cost
- $145K
- Antibiotic Claims
- 20
Patient Demographics
- Average Patient Age
- 74.8 years
- Avg HCC Risk Score
- 1.27
- Gender Split
- 54% female / 46% male
- Age Distribution
- <65: 38, 65-74: 405, 75-84: 308, 85+: 99
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Hitesh Patel, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Latanoprost
Latanoprost
1,083 claims
- Dorzolamide Hcl
Dorzolamide Hcl
539 claims
- Brimonidine Tartrate 396
Brimonidine Tartrate
396 claims
- Ofloxacin 355
Ofloxacin
355 claims
- Restasis 295
Restasis
295 claims
- Timolol Maleate 280
Timolol Maleate
280 claims
- Alphagan P 275
Alphagan P
275 claims
- Erythromycin 254
Erythromycin
254 claims
| Drug | Claims |
|---|---|
| Latanoprost | 1,083 |
| Dorzolamide Hcl | 539 |
| Brimonidine Tartrate | 396 |
| Ofloxacin | 355 |
| Restasis Cyclosporine | 295 |
| Timolol Maleate | 280 |
| Alphagan P Brimonidine Tartrate | 275 |
| Erythromycin Erythromycin Base | 254 |
| Vyzulta Latanoprostene Bunod | 249 |
| Prednisolone Acetate | 217 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Ophthalmology Physician Overview
How Hitesh Patel, M.D. fits within the Ophthalmology Physician landscape nationally.
22,082
Ophthalmology Physician Providers in US
56
States with Ophthalmology Physician
1,420
Avg Claims per Provider
Hitesh Patel, M.D.'s 5,893 claims are above the specialty average of 1,420.
Nearby Ophthalmology Physician Providers in New Jersey
Other clinicians with the same primary specialty enrolled in New Jersey, drawn from the same CMS NPPES roster as Patel.
Dr. Bryan Abessi
M.D.
Branchburg, NJ
Dr. Atul Agarwala
MD
Irvington, NJ
Dr. Arlene Ahmad
MD
Boonton, NJ
Dr. Adil Ahmed
DO
Brick, NJ
Dr. Scott Aksman
MD
Freehold, NJ
Compare Ophthalmology Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the New Jersey medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Ophthalmology Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
Healthcare Guides
Learn more about finding, verifying, and understanding healthcare providers.
How to Find a Doctor
Step-by-step guide to choosing a provider
Verify Credentials
Check NPI, board certification & license status
Medical Specialties Explained
Who treats what and how specialties differ
Understanding Medicare Claims Data
What prescribing data reveals about a provider
In-Network vs Out-of-Network
How insurance networks affect your costs
Telehealth Guide
Virtual care options and coverage in 2026
Explore New Jersey
Frequently Asked Questions
What is Hitesh Patel, M.D.'s specialty? ▼
Hitesh Patel, M.D. specializes in Ophthalmology Physician and practices in Edison, New Jersey. Credentials: M.D..
How much does Hitesh Patel, M.D. prescribe under Medicare Part D? ▼
In 2023, Hitesh Patel, M.D. wrote 5,893 Medicare Part D claims totaling $1.3M in drug costs for 850 beneficiaries.
What is Hitesh Patel, M.D.'s Medicare quality score? ▼
Hitesh Patel, M.D. has a CMS MIPS Final Score of 85.6/100 (Quality: 100, Cost: 35.3). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Hitesh Patel, M.D. located? ▼
Hitesh Patel, M.D. is located at 228 PLAINFIELD AVE, Edison, NJ, 08817. Phone: (732) 985-5009.
What is Hitesh Patel, M.D.'s NPI number? ▼
Hitesh Patel, M.D.'s National Provider Identifier (NPI) is 1215959622, issued on 07/24/2006.
Does Hitesh Patel, M.D. prescribe more brand-name or generic drugs? ▼
Hitesh Patel, M.D.'s prescribing is 40% brand-name and 60% generic drugs by claim count, with $1.2M in brand drug costs.
How many Ophthalmology Physician providers are there in the US? ▼
There are 22,082 Ophthalmology Physician providers across 56 states in the US. The average Ophthalmology Physician provider writes 1,420 Medicare Part D claims per year.
What drugs does Hitesh Patel, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Hitesh Patel, M.D.'s most frequently prescribed drugs include Latanoprost, Dorzolamide Hcl, Brimonidine Tartrate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Hitesh Patel, M.D. accept Medicare? ▼
Hitesh Patel, M.D. appears in CMS Medicare data with 5,893 Part D claims and 850 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Hitesh Patel, M.D.'s credentials? ▼
Hitesh Patel, M.D.'s NPI is 1215959622 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.