Physician

Kalpesh Patel, M.D.

According to 2025 Medicare claims, Kalpesh Patel, M.D. (NPI: 1831396803) practices neurology in the Albany, GA market, with the plurality of this provider's patient population coming from Dougherty, GA. This provider's primary affiliated billing organization is ALBANY NEUROLOGY AND HEADACHE CENTER (NPI: 1528241833; TIN: 260282502) and primary practice location at 31701-1301. Patel is affiliated with the Caravan Health ACO 50 LLC (ACO ID: A5160), participating under the MSSP model.

Patel's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 523 traditional Medicare patients, billed 19,081 HCPCS/CPT codes, and received $235,705 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 9,367 prescription claims across 1,049 beneficiaries totaling $2,004,216 in drug costs, led by Ultomiris (Ravulizumab-Cwvz). 2022 DME data shows 14 claims. Open Payments data shows 81 records totaling $1,425. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has fallen sharply in recent years, from $828,186 to $235,705. In contrast, Part D prescription costs have risen steadily, from $965,442 to $2,004,216. For DME billing, this smaller-volume category started with an early spike, then settled into a lower baseline, moving from $19,626 to $2,069.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	1,885	17,276	$828,186
2016	1,752	17,534	$744,616
2017	1,734	19,489	$747,162
2018	1,675	21,513	$797,111
2019	1,662	21,572	$758,584
2020	1,357	25,090	$681,804
2021	944	27,409	$444,065
2022	644	21,075	$269,622
2023	583	19,551	$255,893
2024	523	19,081	$235,705

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	1,093	9,199	$965,442
2016	1,095	10,055	$1,359,792
2017	1,181	10,639	$1,623,261
2018	1,182	11,415	$1,992,116
2019	1,237	11,407	$1,838,615
2020	1,264	11,678	$1,582,766
2021	1,181	10,476	$1,640,903
2022	1,054	8,634	$2,108,038
2023	986	8,688	$1,919,439
2024	1,049	9,367	$2,004,216

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	77	325	$17,346
2016	73	283	$7,583
2017	48	165	$3,636
2018	41	175	$3,150
2019	54	228	$3,889
2020	77	299	$6,033
2021	14	202	$3,184
2022	N/R	14	$256
2023	N/R	N/R	N/R
2024	N/R	N/R	N/R

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	71	71	$114
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	39	42	$81
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	485	1,869	$61
99212	Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	165	240	$36
96372	Injection of drug or substance under skin or into muscle	39	60	$10

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Ultomiris	Ravulizumab-Cwvz	12	462	$453,735
Kesimpta Pen	Ofatumumab	35	1,044	$314,997
Ingrezza	Valbenazine Tosylate	31	930	$248,415
Rebif	Interferon Beta-1a/Albumin	12	336	$126,215
Botox	Onabotulinumtoxina	87	7,314	$108,300

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	81	$1,425	Novartis Pharmaceuticals Corporation
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Kalpesh Patel, M.D.?

Tedicare shows public-source Medicare data for Kalpesh Patel, M.D. (NPI 1831396803), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Kalpesh Patel, M.D. have ACO affiliation data?

Kalpesh Patel, M.D. is shown with ACO affiliation data for Caravan Health ACO 50 LLC (MSSP, ACO ID A5160).

What billing organization is linked to Kalpesh Patel, M.D.?

Kalpesh Patel, M.D. is linked to ALBANY NEUROLOGY AND HEADACHE CENTER (billing NPI 1528241833) in the available physician profile data.

Does Kalpesh Patel, M.D. have Open Payments data?

Kalpesh Patel, M.D. has 81 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.