Nimish G Patel, DO
Internal Medicine · San Jose
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- Not verified
- Not the same as out of network.
- Office
- 1
Offices
1 location · Quantum Bay Area Hospitalist Medical Group Inc · 60 clinicians in this group
Looking this up.
Hospitals listed: Good Samaritan Hospital. That is not proof they admit you there this week.
Plan participation
Not verified
We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Patel’s office at (408) 559-2011 to ask if they take your plan before you enroll.
California Medical Board record
Licence C18257 · Cancelled
Licence status: Cancelled · since 1956 · University of Illinois College of Medicine.
License has been voluntarily canceled, or the license has been expired for at least five years and has not been renewed. No practice is permitted.
Matched on the licence number without its letter prefix; check the name before relying on it.
No disciplinary actions, convictions, malpractice judgments or citations in this record.
Hospitals they work in
1 hospital
These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.
- Good Samaritan HospitalSan Jose, CAAcute Care Hospital · Proprietary · Has an emergency department · Birthing-friendlyPart of HCA Healthcare, which runs 185 hospitals in 19 statesPatients rate it 2 of 5 · 67% would definitely recommend itOverall rating: 2 of 5 starsBetter than the national rate — Clostridium Difficile (C.Diff): 0.337, Oct 2024 – Sep 2025
See every measure and the patient survey for Good Samaritan Hospital
Behind the star rating — Deaths: 0 better, 8 the same, 0 worse of 8 measures. Safety: 1 better, 6 the same, 1 worse of 8 measures. Readmissions: 0 better, 5 the same, 4 worse of 9 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.
| Clostridium Difficile (C.Diff)Infections | 0.337 | Better | Oct 2024 – Sep 2025 |
| Abdominopelvic accidental puncture or laceration rateComplications and deaths | 0.75 (0 to 1.67) · 1,340 cases | No different | Jul 2022 – Jun 2024 |
| CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths | 0.84 (0.54 to 1.14) | No different | Jul 2022 – Jun 2024 |
| Death rate among surgical inpatients with serious treatable complicationsComplications and deaths | 143.59 (98.7 to 188.49) · 98 cases | No different | Jul 2022 – Jun 2024 |
| Death rate for CABG surgery patientsComplications and deaths | 1.7 · 45 cases | None | Jul 2022 – Jun 2025 |
| Death rate for COPD patientsComplications and deaths | 7.1 · 100 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart attack patientsComplications and deaths | 12.7 · 270 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart failure patientsComplications and deaths | 11.3 · 573 cases | None | Jul 2022 – Jun 2025 |
| Death rate for pneumonia patientsComplications and deaths | 15.6 · 820 cases | None | Jul 2022 – Jun 2025 |
| Death rate for stroke patientsComplications and deaths | 8.5 · 482 cases | None | Jul 2023 – Jun 2025 |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths | 3.3 · 3,711 cases | None | Jul 2024 – Jun 2025 |
| Iatrogenic pneumothorax rateComplications and deaths | 0.12 (0 to 0.3) · 8,866 cases | No different | Jul 2022 – Jun 2024 |
| In-hospital fall-associated fracture rateComplications and deaths | 0.2 (0.01 to 0.38) · 9,051 cases | No different | Jul 2022 – Jun 2024 |
| Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths | 2.65 (0.74 to 4.56) · 1,929 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative acute kidney injury requiring dialysis rateComplications and deaths | 1.8 (0.21 to 3.39) · 670 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative hemorrhage or hematoma rateComplications and deaths | 2.33 (0.88 to 3.78) · 1,836 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative respiratory failure rateComplications and deaths | 6.73 (0 to 13.46) · 669 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative sepsis rateComplications and deaths | 7.58 (3.96 to 11.19) · 654 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative wound dehiscence rateComplications and deaths | 1.59 (0.13 to 3.04) · 496 cases | No different | Jul 2022 – Jun 2024 |
| Pressure ulcer rateComplications and deaths | 0.27 (0 to 0.87) · 7,373 cases | No different | Jul 2022 – Jun 2024 |
| Rate of complications for hip/knee replacement patientsComplications and deaths | 4.1 · 152 cases | None | Apr 2023 – Mar 2025 |
| Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections | 1.08 | No different | Oct 2024 – Sep 2025 |
| Central Line Associated Bloodstream Infection (ICU + select Wards)Infections | 0.542 | No different | Oct 2024 – Sep 2025 |
| MRSA BacteremiaInfections | 0.484 | No different | Oct 2024 – Sep 2025 |
| SSI - Colon SurgeryInfections | 1.565 | No different | Oct 2024 – Sep 2025 |
| Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits | 15.8 · 327 cases | None | Jul 2023 – Jun 2025 |
| Heart failure (HF) 30-Day Readmission RateUnplanned return visits | 24.2 · 703 cases | None | Jul 2023 – Jun 2025 |
| Hospital return days for heart attack patientsUnplanned return visits | 61.1 · 289 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for heart failure patientsUnplanned return visits | 36.3 · 665 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for pneumonia patientsUnplanned return visits | 25.4 · 856 cases | None | Jul 2022 – Jun 2025 |
| Pneumonia (PN) 30-Day Readmission RateUnplanned return visits | 19 · 978 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission after hip/knee replacementUnplanned return visits | 6.3 · 144 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for CABGUnplanned return visits | 12.3 · 46 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits | 21.2 · 135 cases | None | Jul 2023 – Jun 2025 |
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits | 13.8 (10.1 to 18.6) · 129 cases | No different | Jan 2022 – Dec 2024 |
| Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits | 1.2 (0.9 to 1.5) · 531 cases | No different | Jan 2024 – Dec 2024 |
What patients said (704 patients answered, 24% of those asked)
| Cleanliness | 3 |
| Nurse communication | 3 |
| Doctor communication | 2 |
| Communication about medicines | 2 |
| Discharge information | 3 |
| Overall hospital rating | 2 |
| Quietness | 1 |
| Recommend hospital | 3 |
| Room was "always" clean | 66% |
| Nurses "always" communicated well | 75% |
| Doctors "always" communicated well | 71% |
| Staff "always" explained | 54% |
| Yes, staff "did" give patients this information | 83% |
| Yes, staff "did" give patients information about help after discharge | 81% |
| Doctors "always" explained things so they could understand | 66% |
| Doctors "always" listened carefully | 69% |
| Doctors "always" treated them with courtesy and respect | 78% |
| Patients who gave a rating of "9" or "10" (high) | 63% |
| Staff "always" explained new medications | 68% |
| Nurses "always" explained things so they could understand | 69% |
| Nurses "always" listened carefully | 73% |
| Nurses "always" treated them with courtesy and respect | 82% |
| "Always" quiet at night | 38% |
| "YES", patients would definitely recommend the hospital | 67% |
| Staff "always" explained possible side effects | 40% |
| Yes, staff "did" give patients information about possible symptoms | 86% |
Original Medicare doctor bills
$35,357
Medicare paid this office $35,357 for 168 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 83 | $18,515 | $94 |
| Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes | 24 | $4,536 | $142 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 24 | $3,218 | $134 |
| Initial nursing facility care with high level of medical decision making, per day 50 minutes or more | 13 | $1,984 | $153 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 19 | $1,801 | $62 |
See all 8 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 83 | $18,515 | $94 |
| Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes | 24 | $4,536 | $142 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 24 | $3,218 | $134 |
| Initial nursing facility care with high level of medical decision making, per day 50 minutes or more | 13 | $1,984 | $153 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 19 | $1,801 | $62 |
| Hospital discharge day management, more than 30 minutes | 17 | $1,546 | $91 |
| Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes | 15 | $1,491 | $99 |
| Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualifi | 13 | $1,038 | $27 |
Who their Medicare patients are
168 Original Medicare patients in 2024. Average age 75 · Under 65 14% · 85 and older 24% · Women 55% · Also on Medicaid 67% · Health risk score 2.80. Above the middle of the specialty; the typical internal medicine clinician is at 1.76.
Conditions among them: High blood pressure 75% · Diabetes 54% · Coronary heart disease 50% · Depression 48% · Chronic kidney disease 43% · Heart failure 42% · Dementia 35% · Atrial fibrillation 34% · COPD 33% · Stroke 28% · Cancer 17%.
The office billed $196,371, Medicare allowed $44,696 and paid $35,357; for 385 services of 11 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 168 | 385 | 75 | 2.80 | $196,371 | $35,357 |
| 2023 | 256 | 632 | 79 | 2.56 | $324,802 | $59,493 |
| 2022 | 116 | 502 | 77 | 2.62 | $233,160 | $42,753 |
| 2021 | 68 | 91 | 74 | 2.14 | $39,065 | $9,293 |
| 2020 | 261 | 485 | 75 | 2.04 | $218,587 | $48,232 |
| 2019 | 341 | 726 | 73 | 2.46 | $229,025 | $61,206 |
| 2018 | 385 | 718 | 75 | 2.74 | $164,506 | $55,885 |
| 2017 | 315 | 1,019 | 75 | 2.16 | $260,448 | $63,589 |
| 2016 | 253 | 818 | 74 | 2.13 | $286,717 | $68,502 |
| 2015 | 261 | 802 | 70 | 2.54 | $199,726 | $57,337 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 6 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 142 | $26,146 | $71 |
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 68 | $12,595 | $108 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 60 | $9,376 | $156 |
| Hospital discharge day management, more than 30 minutes | 46 | $4,919 | $105 |
| Critical care, first 30-74 minutes | 23 | $4,323 | $188 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 17 | $1,986 | $117 |
2022: 5 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 81 | $24,493 | $94 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 57 | $11,332 | $65 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 13 | $2,350 | $181 |
| Hospital discharge day management, 30 minutes or less | 28 | $1,857 | $66 |
| Hospital discharge day management, more than 30 minutes | 15 | $1,466 | $98 |
2021: 3 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 30 | $2,783 | $80 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 16 | $2,525 | $158 |
| Initial hospital observation care per day, typically 70 minutes | 16 | $2,226 | $139 |
2020: 10 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 79 | $13,590 | $84 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 70 | $11,757 | $161 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 48 | $5,864 | $62 |
| Critical care, first 30-74 minutes | 29 | $5,783 | $187 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 26 | $2,875 | $111 |
| Hospital discharge day management, more than 30 minutes | 29 | $2,506 | $86 |
| Initial hospital observation care per day, typically 70 minutes | 15 | $2,135 | $142 |
| Follow-up observation care per day, typically 35 minutes | 15 | $1,470 | $82 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 13 | $1,073 | $83 |
| Hospital observation care on day of discharge | 11 | $612 | $56 |
2019: 9 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 171 | $25,477 | $81 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 67 | $10,527 | $157 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 66 | $6,392 | $57 |
| Initial hospital observation care per day, typically 70 minutes | 33 | $4,755 | $144 |
| Hospital discharge day management, more than 30 minutes | 52 | $4,308 | $83 |
| Follow-up observation care per day, typically 35 minutes | 32 | $3,419 | $81 |
| Hospital discharge day management, 30 minutes or less | 31 | $1,806 | $56 |
| Hospital observation care on day of discharge | 27 | $1,580 | $56 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 15 | $1,181 | $79 |
2018: 9 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 119 | $17,821 | $55 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 170 | $17,372 | $99 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 45 | $6,711 | $149 |
| Initial hospital observation care per day, typically 50 minutes | 54 | $5,377 | $100 |
| Hospital discharge day management, more than 30 minutes | 45 | $3,656 | $81 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 16 | $1,137 | $71 |
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 13 | $1,026 | $79 |
| Follow-up observation care per day, typically 25 minutes | 11 | $777 | $56 |
| Hospital observation care on day of discharge | 12 | $607 | $51 |
2017: 11 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 68 | $13,556 | $74 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 124 | $13,410 | $53 |
| Hospital discharge day management, more than 30 minutes | 108 | $9,437 | $79 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 104 | $7,791 | $29 |
| Critical care, first 30-74 minutes | 27 | $6,358 | $155 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 29 | $4,126 | $142 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 16 | $1,583 | $99 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 15 | $1,137 | $76 |
| Hospital discharge day management, 30 minutes or less | 19 | $970 | $51 |
| Hospital observation care on day of discharge | 17 | $907 | $53 |
| Follow-up observation care per day, typically 15 minutes | 14 | $607 | $28 |
2016: 8 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 136 | $29,479 | $79 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 71 | $11,129 | $150 |
| Hospital discharge day management, more than 30 minutes | 97 | $8,422 | $79 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 75 | $7,465 | $54 |
| Critical care, first 30-74 minutes | 20 | $4,754 | $170 |
| Hospital discharge day management, 30 minutes or less | 38 | $2,066 | $53 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 19 | $1,965 | $103 |
| Hospital observation care on day of discharge | 15 | $819 | $55 |
2015: 6 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 130 | $18,123 | $55 |
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 89 | $17,687 | $79 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 41 | $6,455 | $154 |
| Hospital discharge day management, 30 minutes or less | 102 | $5,705 | $55 |
| Hospital discharge day management, more than 30 minutes | 24 | $1,940 | $81 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 14 | $1,660 | $104 |
Medicaid work
$12,351 in 2024
Medicaid paid $12,351 for 340 billed services this clinician did in 2024, up to 40 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES | 278 | $9,919 |
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 19 | $733 |
| 1ST HOSP IP/OBS HIGH 75 | 12 | $721 |
| Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter | 19 | $508 |
| Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter | 12 | $470 |
| 2024 | 340 | 5 | 40 | $12,351 |
| 2023 | 360 | 2 | 26 | $3,533 |
| 2022 | 309 | 2 | 20 | $3,699 |
| 2021 | 184 | 10 | 20 | $0 |
| 2020 | 119 | 3 | 14 | $3,160 |
| 2019 | 197 | 3 | 30 | $3,843 |
| 2018 | 158 | 2 | 19 | $1,052 |
See the largest Medicaid services in earlier years
2023
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 332 | $2,890 |
| 1ST HOSP IP/OBS HIGH 75 | 28 | $643 |
2022
| SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES | 194 | $2,422 |
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 115 | $1,278 |
2021
| Pain severity quantified; no pain present (COA) (ONC) | 20 | $0 |
| Medication list documented in medical record (COA) | 20 | $0 |
| Review of all medications by a prescribing practitioner or clinical pharmacist (such as, prescriptions, OTCs, herbal therapies and supplements) documented in the medical record (COA) | 20 | $0 |
| FXNL STATUS ASSESSED | 20 | $0 |
| BODY MASS INDEX DOCD | 18 | $0 |
| Most recent systolic blood pressure less than 130 mm Hg (DM) (HTN, CKD, CAD) | 17 | $0 |
| Most recent diastolic blood pressure less than 80 mm Hg (HTN, CKD, CAD) (DM) | 20 | $0 |
| HOME/RES VST EST LOW MDM 30 | 13 | $0 |
| Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 16 | $0 |
| Blood pressure has a systolic value of < 140 and a diastolic value of < 90 | 20 | $0 |
2020
| SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES | 52 | $1,642 |
| 1ST HOSP IP/OBS HIGH 75 | 18 | $1,067 |
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 49 | $451 |
2019
| SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES | 158 | $3,547 |
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 24 | $296 |
| Advance Care Planning discussed and documented advance care plan or surrogate decision maker documented in the medical record (DEM) (GER, Pall Cr) | 15 | $0 |
2018
| 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES | 112 | $894 |
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 46 | $158 |
Money from drug and device companies
$62 in 2024
| 2024 | 1 | 3 | None | $62 |
| 2023 | 1 | 1 | None | $125 |
| 2022 | 1 | 1 | None | $38 |
| 2020 | 1 | 1 | None | $17 |
| 2019 | 1 | 1 | None | $14 |
Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.
A payment is not proof that care is biased.
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | Lifevest | $62 | 3 payments
|
See all 3 published payments
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | Meals · 2024-06-12 | Lifevest | $21 |
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | Meals · 2024-04-24 | Lifevest | $24 |
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | Meals · 2024-03-21 | Lifevest | $17 |
See earlier years (2023, 2022, 2020, 2019)
2023: $125
| Janssen Pharmaceuticals | Xarelto | $125 | 1 payment
|
2022: $38
| Novartis Pharmaceuticals | Entresto | $38 | 1 payment
|
2020: $17
| Janssen Pharmaceuticals | Xarelto | $17 | 1 payment
|
2019: $14
| Pfizer | Chantix | $14 | 1 payment
|
Professional record
- NPI
- 1184901001
- Licence
- CA 18257, KY 03776California C18257: Cancelled
- Trained
- West Virginia School of Osteopathic Medicine, 2011
- Gender
- Male
More record details
- Sole proprietor
- Yes
- Taxonomy
- Internal medicine (207R00000X); Hospitalist (208M00000X); Student in a training program (390200000X)
- Mailing address
- 4121 Mckinney Ave Apt 40, Dallas, TX, 75204
- NPI first listed
- 2011-11-06
- NPI last updated
- 2026-08-07
- NPI record certified
- 2026-08-07
This is when the NPI record was last certified, not a medical board exam.
Extra NPI addresses: 2121 Santa Monica Blvd, Santa Monica, CA, 90404