NPI registry status
Active
2026 NPPES data Cardiovascular Disease Physician NPI 1043290372 MD
Verify on CMS → Nainesh Patel, MD
Cardiovascular Disease Physician in Pottstown, Pennsylvania.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 25,298 in Cardiovascular Disease 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
7K
Medicare Part D claims · 1K beneficiaries · Cardiovascular Disease Physician avg: 3K
Generic prescribing
83%
generic claims · 17% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
94.7/100
▲ 11 pts above national avg 83.5 · Exceptional
Industry payments
$309.54
6 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2024
What the federal data shows
Nainesh Patel, MD reported a CMS MIPS final score of 94.7/100 - above the 83.5 national average - and filed 6,900 Medicare Part D claims in 2024.
- 94.7/100
- MIPS score · +11 vs avg
- 7K
- Part D claims, 2024
- 83%
- 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.
Federal trust snapshot
What official records show about Nainesh Patel, MD
Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1043290372), first enumerated 01/20/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 6,900 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- Reported
CMS quality reporting (MIPS)
Reported a CMS MIPS final score of 94.7/100 in the Quality Payment Program — a federal quality measure, not a patient review.
Source: CMS Quality Payment Program
- Reported
Board certification signal
Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.
- Reported
Hospital affiliations
1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.
Source: CMS Care Compare
- Reported
Industry payment transparency
$309.54 in reported industry payments (6 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.
Source: CMS Open Payments
- State context
State board disciplinary context
Pennsylvania statewide board action statistics are published annually — these figures describe aggregate state activity, not Nainesh Patel, MD's individual license status. Verify directly with the state medical board.
Source: PA-BOM annual report 2023
- Not in federal data
Individual sanction lookup
PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.
Source: State medical board / FSMB
This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.
CMS NPPES provider registry desk
NPI 1043290372 · Cardiovascular Disease Physician
NPI-10 · ENUM-LEGACY · TAX-MID · MIPS-ELITE · RX-MID · BOOK-LIGHT · PHOTO-FINISH
- NPI-10 1043290372
- ENUM-LEGACY 2006
- TAX-MID 25K Cardiovascular Disease
- MIPS-ELITE 94.7/100
- RX-MID 6,900
- BOOK-LIGHT 1,381 in Pennsylvania
- PHOTO-FINISH Allen Atchley · ±0.0
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Patel · this pro…
Patel · this provider
94.7 MIPS pts
- Vadim Levin · near
Vadim Levin
94.7 MIPS pts
- Benjamin Yang · …
Benjamin Yang
94.7 MIPS pts
- Rajjit Abrol · h…
Rajjit Abrol
94.8 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Nainesh Patel, MD'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.
95 ≥ 73rd percentile 73% 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 Nainesh Patel, MD sits
This provider among cardiovascular disease physician peers
Across the 7,999 cardiovascular disease physician providers who report both Medicare Part D prescribing and a MIPS quality score, Nainesh Patel, MD writes more Part D claims than 87% of them and scores higher on MIPS quality than 75% - placing this provider in the high-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one cardiovascular disease physician peer from a representative sample of 60; the gold marker is Nainesh Patel, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Nainesh Patel, MD 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 Nainesh Patel, MD?
High performer (top quartile)Primary specialty
Cardiovascular Disease Physician
Medicare Part D claims
6,900 119% vs specialty avg
MIPS final score
94.7/100 11.2 pts vs avg
Specialty distribution in Pennsylvania
How Cardiovascular Disease Physician compares to other specialties among Pennsylvania providers
Medicare quality performance, MIPS
Nainesh Patel, MD's 2023 MIPS final score plotted against the Cardiovascular Disease Physician national average
- MIPS Final Score
- 94.7/100
- vs 83.5 national avg · 2023 performance year
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).
Practice Address
Provider Details
| NPI | 1043290372 |
|---|---|
| Specialty | Cardiovascular Disease Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 01/20/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
94.7421
Final Score
Measured-score avg: 83.5
98.5832
Quality
85.557
Cost
98
Promoting Interoperability
Reporting: Group practice
Hospital and facility affiliations
Facilities where Nainesh Patel, MD 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.
Phoenixville Clinic Company LLC
Phoenixville, PA
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 Nainesh Patel, MD. Source: openpaymentsdata.cms.gov.
Total received
$310
Largest payer
ShockWave 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 - Pennsylvania PA-BOM 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 ~45K Pennsylvania medical licensees in 2023 - they are NOT specific to Nainesh Patel, MD. To verify Nainesh Patel, MD's current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases
PA-BOM 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 Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Brand vs generic prescribing mix · Typical
Nainesh Patel, MD - brand share 17.0%
Cardiovascular Disease Physician average
17% brand-name claims vs 83% generic, on 6,900 2024 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 2024.
6,900
Total Claims
$1.2M
Total Drug Cost
1,121
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 17,172.733
- Total Day Supply
- 513,340
- Brand vs Generic
- 17% brand / 83% generic
- Brand Drug Cost
- $1.1M
- Generic Drug Cost
- $105K
- Antibiotic Claims
- 11
Patient Demographics
- Average Patient Age
- 76.8 years
- Avg HCC Risk Score
- 1.62
- Gender Split
- 50% female / 50% male
- Age Distribution
- <65: 57, 65-74: 383, 75-84: 484, 85+: 197
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What Nainesh Patel, MD prescribes most
Top Medicare Part D drugs by claim count, 2024
- Metoprolol Succinate
Metoprolol Succinate
782 claims
- Eliquis
Eliquis
732 claims
- Atorvastatin Calcium
Atorvastatin Calcium
617 claims
- Losartan Potassium
Losartan Potassium
414 claims
- Amlodipine Besylate
Amlodipine Besylate
362 claims
- Furosemide
Furosemide
348 claims
- Lisinopril
Lisinopril
324 claims
- Rosuvastatin Calcium 241
Rosuvastatin Calcium
241 claims
| Drug | Claims |
|---|---|
| Metoprolol Succinate | 782 |
| Eliquis Apixaban | 732 |
| Atorvastatin Calcium | 617 |
| Losartan Potassium | 414 |
| Amlodipine Besylate | 362 |
| Furosemide | 348 |
| Lisinopril | 324 |
| Rosuvastatin Calcium | 241 |
| Carvedilol | 224 |
| Metoprolol Tartrate | 222 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Cardiovascular Disease Physician Overview
How Nainesh Patel, MD fits within the Cardiovascular Disease Physician landscape nationally.
25,298
Cardiovascular Disease Physician Providers in US
54
States with Cardiovascular Disease Physician
3,149
Avg Claims per Provider
Nainesh Patel, MD's 6,900 claims are above the specialty average of 3,149.
Nationwide Cardiovascular Disease Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Patel, both outside Pennsylvania so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (94.7 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Cardiovascular Disease Physician Providers in Pennsylvania
Other clinicians with the same primary specialty enrolled in Pennsylvania, drawn from the same CMS NPPES roster as Patel.
One of 1,381 Cardiovascular Disease Physician providers enrolled in Pennsylvania, 5 are shown here.
Dr. Abdul Abbasi
MD
Uniontown, PA
Dr. Richard Abramowitz
MD
Kingston, PA
Dr. Sandra Abramson
MD
Wynnewood, PA
Dr. Elizabeth Adams
DO
Hershey, PA
Dr. David Addley
D.O.
Philadelphia, PA
Compare Cardiovascular Disease Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Nainesh Patel, MD's specialty? ▼
Nainesh Patel, MD specializes in Cardiovascular Disease Physician and practices in Pottstown, Pennsylvania. Credentials: MD.
How much does Nainesh Patel, MD prescribe under Medicare Part D? ▼
In 2024, Nainesh Patel, MD wrote 6,900 Medicare Part D claims totaling $1.2M in drug costs for 1,121 beneficiaries.
What is Nainesh Patel, MD's Medicare quality score? ▼
Nainesh Patel, MD has a CMS MIPS Final Score of 94.7/100 (Quality: 98.6, Cost: 85.6). 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 Nainesh Patel, MD located? ▼
Nainesh Patel, MD is located at 1591 MEDICAL DR, Pottstown, PA, 19464. Phone: (610) 326-8005.
What is Nainesh Patel, MD's NPI number? ▼
Nainesh Patel, MD's National Provider Identifier (NPI) is 1043290372, issued on 01/20/2006.
Does Nainesh Patel, MD prescribe more brand-name or generic drugs? ▼
Nainesh Patel, MD's prescribing is 17% brand-name and 83% generic drugs by claim count, with $1.1M in brand drug costs.
How many Cardiovascular Disease Physician providers are there in the US? ▼
There are 25,298 Cardiovascular Disease Physician providers across 54 states in the US. The average Cardiovascular Disease Physician provider writes 3,149 Medicare Part D claims per year.
What drugs does Nainesh Patel, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, Nainesh Patel, MD's most frequently prescribed drugs include Metoprolol Succinate, Eliquis, Atorvastatin Calcium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Nainesh Patel, MD accept Medicare? ▼
Nainesh Patel, MD appears in CMS Medicare data with 6,900 Part D claims and 1,121 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Nainesh Patel, MD's credentials? ▼
Nainesh Patel, MD's NPI is 1043290372 with credentials MD. 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 (2024). 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 August 2026 (NPPES) / 2024 (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 August 2026.