2026 NPPES data Internal Medicine Physician NPI 1003194515
Verify on CMS →

Vishal Patel

Internal Medicine Physician in Wexford, 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 172,858 in 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
321
Medicare Part D claims · 153 beneficiaries · Internal Medicine Physician avg: 3K
MIPS score
77.5/100
▼ 6 pts below national avg 83.1 · Above neutral
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Vishal Patel reported a CMS MIPS final score of 77.5/100 - below the 83.1 national average - and filed 321 Medicare Part D claims in 2023.

77.5/100
MIPS score · -6 vs avg
321
Part D claims, 2023
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.

Vishal Patel's MIPS score vs every scored U.S. clinician

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

78 24th percentile higher than 24% 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%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 90+: 189,403 scored providers (40%). Above this entry. 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 Vishal Patel 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, Vishal Patel writes more Part D claims than 34% of them and scores higher on MIPS quality than 24% - placing this provider in the lower-volume, lower-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, percentilePart D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 48Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 43Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 85Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 53Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 60Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 13Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 12Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 27Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 10Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 17Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 33Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 2Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 73Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 15Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 42Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 35Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 5Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 28Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 87Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 72Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 57Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 82Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 80Vishal Patel-Part D claim volume, percentile in specialty: 34 · MIPS quality, percentile: 24
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 Vishal Patel. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

Board certification likely (heuristic, not verified)

Vishal Patel practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations - 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 Vishal Patel?

Below national average

NPI registry status

Active

Issued 08/01/2011

NPI 1003194515

Primary specialty

Internal Medicine Physician

High-volume

172,858 US NPIs in this specialty

Medicare Part D claims

321 88% vs specialty avg

2023 prescription claims

Specialty avg: 2,716

MIPS final score

77.5/100 5.6 pts vs avg

Above neutral band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Internal Medicine Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Largest specialties in Pennsylvania (% of in-state providers)

Student in an Organized Health Care Education/Training Program - 5.6%Student in an Organized Health Care Education/Training Program5.6%Pharmacist - 5%Pharmacist5%Physical Therapist - 4.9%Physical Therapist4.9%Mental Health Counselor - 3.9%Mental Health Counselor3.9%Internal Medicine Physician - 3.3%Internal Medicine Physician3.3%Professional Counselor - 3.2%Professional Counselor3.2%
Largest specialties in Pennsylvania (% of in-state providers)

Medicare quality performance, MIPS

Vishal Patel's 2023 MIPS final score plotted against the Internal Medicine Physician national average

Below national average
MIPS Final Score
77.5/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Internal Medicine Physician) - 77.5/100 vs national avg 83.1

0%100%National avg83%77.5%
MIPS final score (Internal Medicine Physician) - 77.5/100 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).

Vishal Patel appears in the CMS NPPES registry as a Internal Medicine Physician provider at 12351 PERRY HWY, Wexford, PA, 15090, with a listed phone of (412) 359-3030. NPI 1003194515 was issued on 08/01/2011. 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 321 prescription claims written by this provider, covering 153 Medicare beneficiaries and totaling roughly $23K in drug spend, with an opioid prescribing rate of 7.5%. 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 77.5/100 for the 2023 performance year (Quality 68.6, Cost 56.4), 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

12351 PERRY HWY
Wexford, PA 15090

Provider Details

NPI 1003194515
Specialty Internal Medicine Physician
Gender Male
NPI Issued 08/01/2011

CMS Quality Score (MIPS)

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

77.5068
Final Score
Avg: 83.1
68.6144
Quality
56.4081
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where Vishal 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.

Allegheny Clinic
Grove City, PA
University OF Pittsburgh Physicians
Monroeville, 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).

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 Vishal Patel. To verify Vishal 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.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

321
Total Claims
$23K
Total Drug Cost
153
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
348
Total Day Supply
7,086
Generic Drug Cost
$4K
Opioid Claims
24 (7.5% rate)
Antibiotic Claims
79

Patient Demographics

Average Patient Age
74.6 years
Avg HCC Risk Score
2.15
Gender Split
57% female / 43% male
Age Distribution
<65: 20, 65-74: 53, 75-84: 49, 85+: 31

Top Prescribed Drugs (Medicare Part D)

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

What Vishal Patel 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
Carvedilol
18
Amoxicillin-Clavulanate Potass
Amoxicillin/Potassium Clav
17
Prednisone
15
Oxycodone Hcl
14
Ciprofloxacin Hcl
11
Doxycycline Hyclate
11
Metoprolol Tartrate
11

* 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 Vishal Patel 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

Vishal Patel's 321 claims are below the specialty average of 2,716.

Nearby 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.

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 Pennsylvania 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 Vishal Patel's specialty?
Vishal Patel specializes in Internal Medicine Physician and practices in Wexford, Pennsylvania.
How much does Vishal Patel prescribe under Medicare Part D?
In 2023, Vishal Patel wrote 321 Medicare Part D claims totaling $23K in drug costs for 153 beneficiaries.
What is Vishal Patel's Medicare quality score?
Vishal Patel has a CMS MIPS Final Score of 77.5/100 (Quality: 68.6, Cost: 56.4). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Vishal Patel located?
Vishal Patel is located at 12351 PERRY HWY, Wexford, PA, 15090. Phone: (412) 359-3030.
What is Vishal Patel's NPI number?
Vishal Patel's National Provider Identifier (NPI) is 1003194515, issued on 08/01/2011.
Does Vishal Patel prescribe opioids?
Yes, Vishal Patel had 24 opioid claims in 2023 with an opioid prescribing rate of 7.5%.
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 Vishal Patel prescribe most often?
Based on 2023 Medicare Part D data, Vishal Patel's most frequently prescribed drugs include Carvedilol, Amoxicillin-Clavulanate Potass, Prednisone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Vishal Patel accept Medicare?
Vishal Patel appears in CMS Medicare data with 321 Part D claims and 153 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Vishal Patel's credentials?
Vishal Patel's NPI is 1003194515. 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

Compiled from official public sources by the PlainDoctor editorial team.