2026 NPPES data Internal Medicine Physician NPI 1295056950 M.D.
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Krunal Patel, M.D.

Internal Medicine Physician in Worcester, Massachusetts. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
449
Medicare Part D claims · 262 beneficiaries · Internal Medicine Physician avg: 3K
Generic prescribing
77%
generic claims · 23% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
97/100
▲ 14 pts above national avg 83.1 · Exceptional
Industry payments
$309.86
6 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

Krunal Patel, M.D. reported a CMS MIPS final score of 97/100 — above the 83.1 national average — and filed 449 Medicare Part D claims in 2023.

97/100
MIPS score · +14 vs avg
449
Part D claims, 2023
77%
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.

Krunal Patel, M.D.'s MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

97 Top 15% higher than 85% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored 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.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where Krunal Patel, M.D. sits

This provider among internal medicine physician peers

Across the 36,260 internal medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Krunal Patel, M.D. writes more Part D claims than 42% of them and scores higher on MIPS quality than 85% — placing this provider in the lower-volume, high-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

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume — percentile in specialtyMIPS quality — percentile
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one internal medicine physician peer from a representative sample of 60; the gold marker is Krunal 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)

Krunal 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 Krunal Patel, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 06/17/2010

NPI 1295056950

Primary specialty

Internal Medicine Physician

High-volume

172,858 US NPIs in this specialty

Medicare Part D claims

449 83% vs specialty avg

2023 prescription claims

Specialty avg: 2,716

MIPS final score

97/100 13.9 pts vs avg

Exceptional band

vs 83.1 national avg

Specialty distribution in Massachusetts

How Internal Medicine Physician compares to other specialties among Massachusetts providers

Massachusetts providers

Internal Medicine Physician share within Massachusetts

1. Internal Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Internal Medicine Physician share within Massachusetts

Medicare quality performance — MIPS

Krunal Patel, M.D.'s 2023 MIPS final score plotted against the Internal Medicine Physician national average

High performer (top quartile)
MIPS Final Score
97/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Internal Medicine Physician) — 97/100 vs national avg 83.1

0%100%National avg83%97%
MIPS final score (Internal Medicine Physician) — 97/100 vs national avg 83.1

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).

Krunal Patel, M.D. appears in the CMS NPPES registry as a Internal Medicine Physician provider holding M.D. credentials at 55 LAKE AVE N, Worcester, MA, 01655, with a listed phone of (508) 334-3068. NPI 1295056950 was issued on 06/17/2010. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Patel most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 449 prescription claims written by this provider, covering 262 Medicare beneficiaries and totaling roughly $211K in drug spend, split 23% brand-name and 77% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 97/100 for the 2023 performance year (Quality 78.1), compared with the national average of 83.1.

Internal Medicine Physician is a high-volume specialty nationwide, with 172,858 enrolled providers across 56 states and an average of 2,716 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

55 LAKE AVE N
Worcester, MA 01655

Provider Details

NPI 1295056950
Specialty Internal Medicine Physician
Credentials M.D.
Gender Male
NPI Issued 06/17/2010

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

97.0218
Final Score
Avg: 83.1
78.0983
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where Krunal 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.

Umass Memorial Medical Group Inc
Worcester, MA

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 Krunal Patel, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$310

Largest payer

Inari Medical, 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.

License & disciplinary context — Massachusetts BORIM 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~38K Massachusetts medical licensees in 2023 — they are NOT specific to Krunal Patel, M.D.. To verify Krunal Patel, M.D.'s current license status, search the BORIM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

80
Total board actions, Massachusetts 2023
Across 78 cases
2.11
Actions per 1,000 licensees
Massachusetts statewide rate
probation
Most common action type
29 cases

BORIM publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Massachusetts disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

Krunal Patel, M.D. — brand share 23.0%
Specialty average (est.)

23% brand-name claims vs 77% generic, on 449 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.

449
Total Claims
$211K
Total Drug Cost
262
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
640
Total Day Supply
11,756
Brand vs Generic
23% brand / 77% generic
Brand Drug Cost
$193K
Generic Drug Cost
$18K

Patient Demographics

Average Patient Age
69.6 years
Avg HCC Risk Score
1.22
Gender Split
52% female / 48% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What Krunal Patel, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Sodium Chloride
0.9 % Sodium Chloride
52
Omeprazole
41
Pantoprazole Sodium
15
Famotidine
12
Humira(Cf)
Adalimumab
12
Gavilyte-C
"Peg3350/Sod Sulf
N/A
Gavilyte-G
"Peg3350/Sod Sulf
N/A
Peg-3350 And Electrolytes
"Peg3350/Sod Sulf
N/A
Sod Sulf-Potass Sulf-Mag Sulf
"Sodium
N/A

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Internal Medicine Physician Overview

How Krunal Patel, M.D. fits within the Internal Medicine Physician landscape nationally.

172,858
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider

Krunal Patel, M.D.'s 449 claims are below the specialty average of 2,716.

Nearby Internal Medicine Physician Providers in Massachusetts

Other clinicians with the same primary specialty enrolled in Massachusetts, drawn from the same CMS NPPES roster as Patel.

Compare Internal Medicine 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 Massachusetts medical board — federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Internal Medicine 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.

Frequently Asked Questions

What is Krunal Patel, M.D.'s specialty?
Krunal Patel, M.D. specializes in Internal Medicine Physician and practices in Worcester, Massachusetts. Credentials: M.D..
How much does Krunal Patel, M.D. prescribe under Medicare Part D?
In 2023, Krunal Patel, M.D. wrote 449 Medicare Part D claims totaling $211K in drug costs for 262 beneficiaries.
What is Krunal Patel, M.D.'s Medicare quality score?
Krunal Patel, M.D. has a CMS MIPS Final Score of 97/100 (Quality: 78.1). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Krunal Patel, M.D. located?
Krunal Patel, M.D. is located at 55 LAKE AVE N, Worcester, MA, 01655. Phone: (508) 334-3068.
What is Krunal Patel, M.D.'s NPI number?
Krunal Patel, M.D.'s National Provider Identifier (NPI) is 1295056950, issued on 06/17/2010.
Does Krunal Patel, M.D. prescribe more brand-name or generic drugs?
Krunal Patel, M.D.'s prescribing is 23% brand-name and 77% generic drugs by claim count, with $193K in brand drug costs.
How many Internal Medicine Physician providers are there in the US?
There are 172,858 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
What drugs does Krunal Patel, M.D. prescribe most often?
Based on 2023 Medicare Part D data, Krunal Patel, M.D.'s most frequently prescribed drugs include Sodium Chloride, Omeprazole, Pantoprazole Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Krunal Patel, M.D. accept Medicare?
Krunal Patel, M.D. appears in CMS Medicare data with 449 Part D claims and 262 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Krunal Patel, M.D.'s credentials?
Krunal Patel, M.D.'s NPI is 1295056950 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

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