Active NPI 1790795649 Individual Practitioner Male Practitioner

Dr. Nirav Rameshchandra Pathak , MD

Hospitalist • Sumter, SC

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Nirav Pathak, MD is a certified Hospitalist practicing in Sumter, SC. With approximately 33 years of clinical experience since completing medical education in 1993, Dr. Pathak delivers high-quality medical care to the local community at 129 N WASHINGTON ST.

Dr. Pathak is affiliated with Prisma Health Medical Group-Midlands and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, hospital discharge day management, more than, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

129 N Washington St

Sumter, SC 291504949

Telephone 8037749680

Fax 8034343955

Associated Practice Facility / Clinic

🏢 Tuomey Obgyn Services Llc Facility NPI 1518936822

Medicare Profile & Education

Medical School

Other

Graduation Year

1993

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Hospitalist in Sumter, SC

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

33 Yrs +16.0 yrs vs City Avg

City Avg: 17.0 Yrs

State Avg: 17.1 Yrs

Regional Practice Density

22 Specialists

Practicing in Sumter, SC (471 Statewide)

Telehealth Adoption Rate

4.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

49.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Pathak (33 Years) 33 Yrs

Sumter Specialty Average (17.0 Years) 17.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	260	126	$149.56	$77.54
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	121	83	$225.10	$117.54
99239 Hospital discharge day management, more than 30 minutes	96	96	$219.02	$113.13
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$277.00	$129.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	241	131	$149.00	$76.33
99239 Hospital discharge day management, more than 30 minutes	95	90	$218.00	$110.13
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	84	61	$215.55	$114.85
99231 Follow-up hospital inpatient care per day, typically 15 minutes	34	14	$83.00	$47.83
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$277.00	$116.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	306	120	$149.00	$68.10
99231 Follow-up hospital inpatient care per day, typically 15 minutes	71	17	$83.00	$37.18
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	69	56	$214.00	$98.55
99239 Hospital discharge day management, more than 30 minutes	65	64	$218.00	$98.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	415	147	$149.00	$69.08
99239 Hospital discharge day management, more than 30 minutes	72	72	$218.00	$102.65
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	53	40	$214.00	$98.56
99217 Hospital observation care on day of discharge	25	25	$151.00	$69.62
99225 Subsequent observation care, typically 25 minutes per day	13	12	$143.00	$66.20
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$277.00	$131.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	514	183	$142.19	$71.14
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	96	78	$204.38	$102.51
99239 Hospital discharge day management, more than 30 minutes	70	69	$209.71	$104.59
99231 Follow-up hospital inpatient care per day, typically 15 minutes	53	16	$77.06	$38.49
99217 Hospital observation care on day of discharge	30	30	$144.00	$68.89
99225 Subsequent observation care, typically 25 minutes per day	21	14	$141.38	$71.15
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	16	16	$267.38	$134.56

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	463	172	$140.00	$69.98
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	104	91	$202.00	$100.10
99239 Hospital discharge day management, more than 30 minutes	88	88	$207.23	$102.97
99231 Follow-up hospital inpatient care per day, typically 15 minutes	67	21	$76.00	$37.84
99225 Subsequent observation care, typically 25 minutes per day	36	17	$141.00	$70.30
99217 Hospital observation care on day of discharge	32	32	$141.00	$70.09
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	23	23	$266.00	$131.47
99220 Hospital observation care, typically 70 minutes	19	19	$360.00	$178.64
99219 Hospital observation care, typically 50 minutes	19	19	$263.00	$130.71
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	16	$393.00	$194.53
99238 Hospital discharge day management, 30 minutes or less	13	13	$140.00	$70.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	420	154	$140.00	$69.61
99231 Follow-up hospital inpatient care per day, typically 15 minutes	103	21	$76.00	$37.47
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	99	80	$202.00	$99.76
99224 Subsequent observation care, typically 15 minutes per day	61	11	$77.00	$38.16
99239 Hospital discharge day management, more than 30 minutes	56	56	$208.00	$102.93
99225 Subsequent observation care, typically 25 minutes per day	40	18	$141.00	$70.06
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	38	38	$264.34	$130.49
99238 Hospital discharge day management, 30 minutes or less	21	21	$140.00	$69.72
99219 Hospital observation care, typically 50 minutes	19	19	$263.00	$124.51
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	13	$363.92	$193.86
99217 Hospital observation care on day of discharge	13	13	$141.00	$69.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	476	195	$117.39	$69.14
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	170	116	$171.00	$99.85
99231 Follow-up hospital inpatient care per day, typically 15 minutes	108	32	$85.00	$37.52
99239 Hospital discharge day management, more than 30 minutes	90	90	$180.00	$102.63
99225 Subsequent observation care, typically 25 minutes per day	30	11	$95.00	$69.79
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	20	20	$267.00	$193.69
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	19	19	$203.00	$130.68
99238 Hospital discharge day management, 30 minutes or less	16	16	$125.00	$69.21
99220 Hospital observation care, typically 70 minutes	11	11	$275.00	$177.79

Medical Specialties & State Licenses

CMS Verified: 2025-03-25

Hospitalist Primary Specialty

NUCC Taxonomy Code: 208M00000X

State License SC 26303

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Family Medicine

NUCC Taxonomy Code: 207Q00000X

State License SC 26303

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

263039 (SC)

Hospital & Practice Group Affiliations

Prisma Health Medical Group-Midlands

129 N Washington St, Sumter, SC 291504949

Phone: 8037749680

Secondary Practice Locations

14 Richland Medical Park Dr Ste 320

Columbia, SC 292036896

Phone: 8034346771

2720 Sunset Blvd

West Columbia, SC 291694810

Phone: 8039367372

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Terry Godfrey , MD

Hospitalist

NPI 1003806266

Doctor of Medicine (M.D.)

Dr. Gopalbhai Vaghela , MD

Hospitalist

NPI 1013221589

Doctor of Medicine (M.D.)

Dr. Michael Lever , MD

Pediatrics

NPI 1023513744

Doctor of Medicine (M.D.)

Kristine Whaley

Nurse Practitioner - Acute Care

NPI 1023865029

Dr. Fritz E Jean Gilles , MD

Internal Medicine

NPI 1033121751

Doctor of Medicine (M.D.)

Dr. Amanda Goins , DO

Internal Medicine

NPI 1043342488

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

📍

Updated Practice Location April 12, 2023

Registered at 129 N WASHINGTON ST, SUMTER, SC 291504949 (Tel: 8037749680)

📍

Updated Business Mailing Address April 12, 2023

Registered at 300 E MCBEE AVE FL 4, GREENVILLE, SC 296012842 (Tel: 8645228603)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 22, 2021

Family Medicine (License #26303 in SC)

📍

Updated Practice Location March 20, 2018

Registered at 14 RICHLAND MEDICAL PARK DR STE 320, COLUMBIA, SC 292036896 (Tel: 8034346771)

📍

Updated Business Mailing Address March 20, 2018

Registered at PO BOX 743904, ATLANTA, GA 303743904 (Tel: 8032967320)

✅

NPI Profile Active January 04, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location January 04, 2008

Registered at 3 MEDICAL PARK RD, SUITE 510, COLUMBIA, SC 292036873 (Tel: 8034346771)

📍

Updated Business Mailing Address January 04, 2008

Registered at PO BOX 402145, ATLANTA, GA 303842145 (Tel: 8032967313)

👤

Provider Name / Credentials Updated January 04, 2008

Recorded as NIRAV PATHAK, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 04, 2008

Family Medicine (License #26303 in SC)

🟢

Initial NPI Registration & Enumeration August 09, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1790795649

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 09, 2006

Last Update: March 25, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

300 E Mcbee Ave Fl 4

Greenville, SC 296012842

Phone: 8645228603

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.