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2026 NPPES data Sleep Medicine (Internal Medicine) Physician NPI 1295723575
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Sanjay Patel

Sleep Medicine (Internal Medicine) Physician in Pittsburgh, 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 932 in Sleep Medicine (Internal Medicine) 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
202
Medicare Part D claims · 28 beneficiaries · Sleep Medicine (Internal Medicine) Physician avg: 1K
Generic prescribing
80%
generic claims · 20% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
77.5/100
▼ 6 pts below national avg 83.5 · Above neutral
Industry payments
$32.4
1 payments · CMS Open Payments (Sunshine Act)
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

Sanjay Patel reported a CMS MIPS final score of 77.5/100 - below the 83.5 national average - and filed 202 Medicare Part D claims in 2024.

77.5/100
MIPS score · -6 vs avg
202
Part D claims, 2024
80%
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 Sanjay Patel

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 1295723575), first enumerated 10/11/2005.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 202 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 77.5/100 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.

    Source: NUCC taxonomy + CMS participation heuristic

  • 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

    $32.4 in reported industry payments (1 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 Sanjay Patel'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 1295723575 · Sleep Medicine (Internal Medicine) Physician

NPI-10 · ENUM-LEGACY · TAX-NARROW · MIPS-BELOW · RX-LIGHT · BOOK-THIN · PHOTO-FINISH

  • NPI-10 1295723575
  • ENUM-LEGACY 2005
  • TAX-NARROW 932
  • MIPS-BELOW 77.5/100
  • RX-LIGHT 202
  • BOOK-THIN 47 in Pennsylvania
  • PHOTO-FINISH Kiran Mehta · ±0.0

MIPS final-score neighbourhood

Same-specialty nationwide peers by CMS final score, not geographic proximity

MIPS pts

What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).

Source CMS Quality Payment Program (MIPS) As of 2023

Sanjay Patel'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.

78 ≥ 20th percentile 20% of 454,083 measured providers are in lower value bands

0–10: 8,684 measured providers (2%). Below this entry. 10–20: 3,008 measured providers (1%). Below this entry. 20–30: 3,069 measured providers (1%). Below this entry. 30–40: 2,746 measured providers (1%). Below this entry. 40–50: 2,928 measured providers (1%). Below this entry. 50–60: 5,882 measured providers (1%). Below this entry. 60–70: 13,906 measured providers (3%). Below this entry. 70–80: 94,570 measured providers (21%). This entry sits in this band. 80–90: 129,887 measured providers (29%). Above this entry. 90+: 189,403 measured providers (42%). Above this entry. This provider 0 100 every measured MIPS clinician, bucketed by value

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 Sanjay Patel sits

This provider among sleep medicine (internal medicine) physician peers

Across the 274 sleep medicine (internal medicine) physician providers who report both Medicare Part D prescribing and a MIPS quality score, Sanjay Patel writes more Part D claims than 30% of them and scores higher on MIPS quality than 19% - placing this provider in the lower-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 100Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 47Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 13Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 78Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 33Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 8Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 88Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 68Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 7Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 53Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 60Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 83Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 12Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 98Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 5Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 2Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 97Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 70Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 85Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 52Sanjay Patel, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 19
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one sleep medicine (internal medicine) physician peer from a representative sample of 60; the gold marker is Sanjay Patel. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
Board certification likely (heuristic, not verified)

Sanjay Patel 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?

Below national average

NPI registry status

Active

Issued 10/11/2005

NPI 1295723575

Primary specialty

Sleep Medicine (Internal Medicine) Physician

Niche

932 US NPIs in this specialty

Medicare Part D claims

202 84% vs specialty avg

2024 prescription claims

Specialty avg: 1,288

MIPS final score

77.5/100 6 pts vs avg

Above neutral band

vs 83.5 national avg

Specialty distribution in Pennsylvania

How Sleep Medicine (Internal Medicine) Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers
Student in an Organized Heal…6%Pharmacist5%Physical Therapist4.8%Mental Health Counselor4%Internal Medicine Physician3.3%Professional Counselor3.2%Sleep Medicine (Internal Med…0%
Largest specialties in Pennsylvania (% of in-state providers)

Medicare quality performance, MIPS

Sanjay Patel's 2023 MIPS final score plotted against the Sleep Medicine (Internal Medicine) Physician national average

Below national average
MIPS Final Score
77.5/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%77.5%
MIPS final score (Sleep Medicine (Internal Medicine) Physician) - 77.5/100 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).

Practice Address

3601 5TH AVE
Pittsburgh, PA 15213
(412) 648-6161

Provider Details

NPI 1295723575
Specialty Sleep Medicine (Internal Medicine) Physician
Gender Male
NPI Issued 10/11/2005

CMS Quality Score (MIPS)

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

77.5068
Final Score
Measured-score avg: 83.5
68.6144
Quality
56.4081
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where Sanjay Patel 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.

University OF Pittsburgh Physicians
Pittsburgh, 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 Sanjay Patel. Source: openpaymentsdata.cms.gov.

Total received

$32

Largest payer

Avadel CNS Pharmaceuticals, LLC

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 Sanjay Patel. To verify Sanjay Patel'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

Sanjay Patel - brand share 20.0%
Sleep Medicine (Internal Medicine) Physician average

20% brand-name claims vs 80% generic, on 202 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.

202
Total Claims
$367K
Total Drug Cost
28
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
241
Total Day Supply
7,178
Brand vs Generic
20% brand / 80% generic
Brand Drug Cost
$364K
Generic Drug Cost
$3K

Patient Demographics

Average Patient Age
66.8 years
Avg HCC Risk Score
1.32
Gender Split
46% female / 54% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.

What Sanjay Patel prescribes most

Top Medicare Part D drugs by claim count, 2024

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2024
Drug Claims
Modafinil
 29
Venlafaxine Hcl Er
Venlafaxine Hcl
28
Dextroamphetamine-Amphetamine
Dextroamphetamine/Amphetamine
24
Zolpidem Tartrate
 13
Dextroamphetamine-Amphet Er
Dextroamphetamine/Amphetamine
12
Belsomra
Suvorexant
11
Wakix
Pitolisant Hcl
11
Xywav
Sodium,calcium,mag,pot Oxybate
11

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

More Sleep Medicine (Internal Medicine) Physician in PA → All providers in Pennsylvania → Compare specialties →

Sleep Medicine (Internal Medicine) Physician Overview

How Sanjay Patel fits within the Sleep Medicine (Internal Medicine) Physician landscape nationally.

932
Sleep Medicine (Internal Medicine) Physician Providers in US
52
States with Sleep Medicine (Internal Medicine) Physician
1,288
Avg Claims per Provider

Sanjay Patel's 202 claims are below the specialty average of 1,288.

Nationwide Sleep Medicine (Internal Medicine) 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 (77.5 here).

Kiran Mehta 77.5 MD Kent Berquist 77.5 KS Darshak Pandya 77.5 GA Payam Pooyan 77.8 VA

Same NPPES enumeration year (2005)

Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.

Luis Guerra Arlington, TX Stacia Sailer Northborough, MA Teresa Jacobs Bellevue, WA Arturo Homma San Antonio, TX

Nearby Sleep Medicine (Internal Medicine) 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 47 Sleep Medicine (Internal Medicine) Physician providers enrolled in Pennsylvania, 5 are shown here.

Dr. Ron Anafi
MD
Philadelphia, PA
Dr. Stephen Basheda
D.O.
Pittsburgh, PA
Dr. Sara Cadman
MD
Philadelphia, PA
Dr. Charles Cantor
MD
Philadelphia, PA
Dr. Sushruta Cerejo
M.D
Pittsburgh, PA

Compare Sleep Medicine (Internal Medicine) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is Sanjay Patel's specialty? ▼
Sanjay Patel specializes in Sleep Medicine (Internal Medicine) Physician and practices in Pittsburgh, Pennsylvania.
How much does Sanjay Patel prescribe under Medicare Part D? ▼
In 2024, Sanjay Patel wrote 202 Medicare Part D claims totaling $367K in drug costs for 28 beneficiaries.
What is Sanjay Patel's Medicare quality score? ▼
Sanjay Patel has a CMS MIPS Final Score of 77.5/100 (Quality: 68.6, Cost: 56.4). 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 Sanjay Patel located? ▼
Sanjay Patel is located at 3601 5TH AVE, Pittsburgh, PA, 15213. Phone: (412) 648-6161.
What is Sanjay Patel's NPI number? ▼
Sanjay Patel's National Provider Identifier (NPI) is 1295723575, issued on 10/11/2005.
Does Sanjay Patel prescribe more brand-name or generic drugs? ▼
Sanjay Patel's prescribing is 20% brand-name and 80% generic drugs by claim count, with $364K in brand drug costs.
How many Sleep Medicine (Internal Medicine) Physician providers are there in the US? ▼
There are 932 Sleep Medicine (Internal Medicine) Physician providers across 52 states in the US. The average Sleep Medicine (Internal Medicine) Physician provider writes 1,288 Medicare Part D claims per year.
What drugs does Sanjay Patel prescribe most often? ▼
Based on 2024 Medicare Part D data, Sanjay Patel's most frequently prescribed drugs include Modafinil, Venlafaxine Hcl Er, Dextroamphetamine-Amphetamine. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Sanjay Patel accept Medicare? ▼
Sanjay Patel appears in CMS Medicare data with 202 Part D claims and 28 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Sanjay Patel's credentials? ▼
Sanjay Patel's NPI is 1295723575. 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

Compiled from official public sources by the editorial process.

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.