SANJAY PATEL, M.D.
Cardiovascular Disease Physician in HICKORY, North Carolina. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What the federal data shows
SANJAY PATEL, M.D. reported a CMS MIPS final score of 75/100 — below the 83.1 national average — and filed 5,243 Medicare Part D claims in 2023.
- 75/100
- MIPS score · -8 vs avg
- 5K
- 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.
SANJAY 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
75 15th percentile higher than 15% of 477,587 scored providers
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
SANJAY 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 SANJAY PATEL, M.D.?
Below national averagePrimary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in North Carolina
How Cardiovascular Disease Physician compares to other specialties among North Carolina providers
Cardiovascular Disease Physician share within North Carolina
Cardiovascular Disease Physician is one of the more visible NUCC categories in North Carolina
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
SANJAY PATEL, M.D.'s 2023 MIPS final score plotted against the Cardiovascular Disease Physician national average
- MIPS Final Score
- 75/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Cardiovascular Disease Physician) — 75/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Specialty volume Cardiovascular Disease Physician US NPIs
75/100 MIPS final score — 8.1 pts below the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Cardiovascular Disease Physician.
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).
SANJAY PATEL, M.D. appears in the CMS NPPES registry as a Cardiovascular Disease Physician provider holding M.D. credentials at 1771 TATE BLVD SE, HICKORY, NC, 28602, with a listed phone of (828) 324-4804. NPI 1326001603 was issued on 04/08/2006. 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 5,243 prescription claims written by this provider, covering 1,075 Medicare beneficiaries and totaling roughly $1.1 million 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 75/100 for the 2023 performance year, compared with the national average of 83.1.
Cardiovascular Disease Physician is a mid-sized specialty nationwide, with 24,795 enrolled providers across 54 states and an average of 3,033 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 | 1326001603 |
|---|---|
| Specialty | Cardiovascular Disease Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 04/08/2006 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm SANJAY PATEL, M.D.'s current license status, disciplinary history, and board certifications with the North Carolina Medical Board in North Carolina before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where SANJAY 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.
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 SANJAY PATEL, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$871
Largest payer
ABIOMED
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 · Typical
23% brand-name claims vs 77% generic, on 5,243 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.
Prescribing Breakdown
- 30-Day Fills
- 12,426
- Total Day Supply
- 370,864
- Brand vs Generic
- 23% brand / 77% generic
- Brand Drug Cost
- $1.1M
- Generic Drug Cost
- $81K
Patient Demographics
- Average Patient Age
- 75.0 years
- Avg HCC Risk Score
- 1.54
- Gender Split
- 41% female / 59% male
- Age Distribution
- <65: 79, 65-74: 437, 75-84: 420, 85+: 139
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What SANJAY PATEL, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Eliquis
Eliquis
792 claims
- Metoprolol Succinate
Metoprolol Succinate
513 claims
- Atorvastatin Calcium
Atorvastatin Calcium
491 claims
- Carvedilol
Carvedilol
354 claims
- Clopidogrel 250
Clopidogrel
250 claims
- Amlodipine Besylate 221
Amlodipine Besylate
221 claims
- Lisinopril 171
Lisinopril
171 claims
- Furosemide 164
Furosemide
164 claims
| Drug | Claims |
|---|---|
| Eliquis Apixaban | 792 |
| Metoprolol Succinate | 513 |
| Atorvastatin Calcium | 491 |
| Carvedilol | 354 |
| Clopidogrel Clopidogrel Bisulfate | 250 |
| Amlodipine Besylate | 221 |
| Lisinopril | 171 |
| Furosemide | 164 |
| Diltiazem 24hr Er (Cd) Diltiazem Hcl | 150 |
| Losartan Potassium | 150 |
* 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 SANJAY PATEL, M.D. fits within the Cardiovascular Disease Physician landscape nationally.
SANJAY PATEL, M.D.'s 5,243 claims are above the specialty average of 3,033.
Nearby Cardiovascular Disease Physician Providers in North Carolina
Other clinicians with the same primary specialty enrolled in North Carolina, drawn from the same CMS NPPES roster as PATEL.
Compare Cardiovascular Disease Physician nationally: see state-by-state distribution →
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Frequently Asked Questions
What is SANJAY PATEL, M.D.'s specialty? ▼
How much does SANJAY PATEL, M.D. prescribe under Medicare Part D? ▼
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Where is SANJAY PATEL, M.D. located? ▼
What is SANJAY PATEL, M.D.'s NPI number? ▼
Does SANJAY PATEL, M.D. prescribe more brand-name or generic drugs? ▼
How many Cardiovascular Disease Physician providers are there in the US? ▼
What drugs does SANJAY PATEL, M.D. prescribe most often? ▼
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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