2026 NPPES data Interventional Cardiology Physician NPI 1568529006 M.D.
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PRAGNESH PATEL, M.D.

Interventional Cardiology Physician in JEFFERSON CITY, Tennessee. 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
5K
Medicare Part D claims · 817 beneficiaries · Interventional Cardiology Physician avg: 3K
Generic prescribing
74%
generic claims · 26% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.1 · [object Object]
Industry payments
$1.8K
73 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: PRAGNESH PATEL, M.D. is a Interventional Cardiology Physician ([object Object]) practicing in JEFFERSON CITY, Tennessee with a Medicare Part D prescribing footprint of 5K claims across 817 beneficiaries — 26% brand-name prescribing . Their CMS MIPS Final Score of 100/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $1.8K across 73 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: PRAGNESH PATEL, M.D. reported a CMS MIPS final score of 100 out of 100, above the 83.1 national average, and filed 5,060 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

PRAGNESH 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).

PRAGNESH PATEL, M.D. at a glance

High performer (top quartile)

NPI registry status

Active

Issued 01/03/2007

NPI 1568529006

Primary specialty

Interventional Cardiology Physician

Niche

3,382 US NPIs in this specialty

Medicare Part D claims

5,060 70% vs specialty avg

2023 prescription claims

Specialty avg: 2,984

MIPS final score

100/100 16.900000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Tennessee

How Interventional Cardiology Physician compares to other specialties among Tennessee providers

Tennessee providers

Interventional Cardiology Physician share within Tennessee

1. Interventional Cardiology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Interventional Cardiology Physician share within Tennessee

Medicare quality performance — MIPS

PRAGNESH PATEL, M.D.'s 2023 MIPS final score plotted against the Interventional Cardiology Physician national average

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

MIPS final score (Interventional Cardiology Physician) — 100/100 vs national avg 83.1

0%100%National avg83%99%
MIPS final score (Interventional Cardiology Physician) — 100/100 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).

PRAGNESH PATEL, M.D. is a Interventional Cardiology Physician provider practicing in JEFFERSON CITY, Tennessee, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1568529006. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

PRAGNESH PATEL, M.D. appears in the CMS NPPES registry as a Interventional Cardiology Physician provider holding M.D. credentials at 120 HOSPITAL DR STE 260, JEFFERSON CITY, TN, 37760, with a listed phone of (423) 839-2525. NPI 1568529006 was issued on 01/03/2007. 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 5,060 prescription claims written by this provider, covering 817 Medicare beneficiaries and totaling roughly $1.3 million in drug spend, split 26% brand-name and 74% 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 100/100 for the 2023 performance year (Quality 94.4615), compared with the national average of 83.1.

Interventional Cardiology Physician is a narrow specialty nationwide, with 3,382 enrolled providers across 53 states and an average of 2,984 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

120 HOSPITAL DR STE 260
JEFFERSON CITY, TN 37760

Provider Details

NPI 1568529006
Specialty Interventional Cardiology Physician
Credentials M.D.
Gender Male
NPI Issued 01/03/2007

CMS Quality Score (MIPS)

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

100
Final Score
Avg: 83.1
94.4615
Quality
98
Promoting Interoperability

Reporting: Individual

Hospital and facility affiliations

Facilities where PRAGNESH 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.

GENESIS HEART AND VASCULAR ASSOCIATES, PLLC
JEFFERSON CITY, TN

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 PRAGNESH PATEL, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$1.8K

Largest payer

AngioDynamics, 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

PRAGNESH PATEL, M.D. — brand share 26.0%
Specialty average (est.)

26% brand-name claims vs 74% generic, on 5,060 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.

5,060
Total Claims
$1.3M
Total Drug Cost
817
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
9,703
Total Day Supply
289,361
Brand vs Generic
26% brand / 74% generic
Brand Drug Cost
$1.2M
Generic Drug Cost
$95K

Patient Demographics

Average Patient Age
71.4 years
Avg HCC Risk Score
1.95
Gender Split
52% female / 48% male
Age Distribution
<65: 165, 65-74: 332, 75-84: 261, 85+: 59

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Clopidogrel
Clopidogrel Bisulfate
402
Atorvastatin Calcium
384
Metoprolol Tartrate
382
Xarelto
Rivaroxaban
337
Eliquis
Apixaban
288
Entresto
Sacubitril/Valsartan
259
Nitroglycerin Patch
Nitroglycerin
200
Metoprolol Succinate
197
Furosemide
169
Carvedilol
162

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

Interventional Cardiology Physician Overview

How PRAGNESH PATEL, M.D. fits within the Interventional Cardiology Physician landscape nationally.

3,382
Interventional Cardiology Physician Providers in US
53
States with Interventional Cardiology Physician
2,984
Avg Claims per Provider

PRAGNESH PATEL, M.D.'s 5,060 claims are above the specialty average of 2,984.

Nearby Interventional Cardiology Physician Providers in Tennessee

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

Compare Interventional Cardiology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is PRAGNESH PATEL, M.D.'s specialty?
PRAGNESH PATEL, M.D. specializes in Interventional Cardiology Physician and practices in JEFFERSON CITY, Tennessee. Credentials: M.D..
How much does PRAGNESH PATEL, M.D. prescribe under Medicare Part D?
In 2023, PRAGNESH PATEL, M.D. wrote 5,060 Medicare Part D claims totaling $1.3M in drug costs for 817 beneficiaries.
What is PRAGNESH PATEL, M.D.'s Medicare quality score?
PRAGNESH PATEL, M.D. has a CMS MIPS Final Score of 100/100 (Quality: 94.4615). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is PRAGNESH PATEL, M.D. located?
PRAGNESH PATEL, M.D. is located at 120 HOSPITAL DR STE 260, JEFFERSON CITY, TN, 37760. Phone: (423) 839-2525.
What is PRAGNESH PATEL, M.D.'s NPI number?
PRAGNESH PATEL, M.D.'s National Provider Identifier (NPI) is 1568529006, issued on 01/03/2007.
Does PRAGNESH PATEL, M.D. prescribe more brand-name or generic drugs?
PRAGNESH PATEL, M.D.'s prescribing is 26% brand-name and 74% generic drugs by claim count, with $1.2M in brand drug costs.
How many Interventional Cardiology Physician providers are there in the US?
There are 3,382 Interventional Cardiology Physician providers across 53 states in the US. The average Interventional Cardiology Physician provider writes 2,984 Medicare Part D claims per year.
What drugs does PRAGNESH PATEL, M.D. prescribe most often?
Based on 2023 Medicare Part D data, PRAGNESH PATEL, M.D.'s most frequently prescribed drugs include Clopidogrel, Atorvastatin Calcium, Metoprolol Tartrate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PRAGNESH PATEL, M.D. accept Medicare?
PRAGNESH PATEL, M.D. appears in CMS Medicare data with 5,060 Part D claims and 817 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PRAGNESH PATEL, M.D.'s credentials?
PRAGNESH PATEL, M.D.'s NPI is 1568529006 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