NPIMap

Individual provider Active NPI

Maulikkumar Arvindbhai Patel, MD

  • Internal Medicine Physician
  • Gray, GA
National Provider Identifier
1013304088
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
83263 Issued in GA
Practice address
1005 Boulder Dr
Gray, GA 31032-6141
Phone
(478) 874-8368
Fax
(678) 540-8623
NPI assigned
Apr 17, 2015
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 83263 GA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 83263 GA

Addresses

Primary practice location

1005 Boulder Dr
Gray, GA 31032-6141

Mailing address

1005 Boulder Dr
Gray, GA 31032-6141
Phone (478) 621-2072

Other practice location 1

4700 Waters Ave
Memorial Health University Medical Center
Savannah, GA 31404-6220
Phone (912) 350-8000

Other practice location 2

1101 Lexington Ave
Savannah, GA 31404-5502
Phone (912) 350-7171

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpatel51595@epicsav.hcadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190719000947 GA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5092018390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Mercer University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Primary Care of Georgia LLCGroup PAC ID 0648421065, 20 clinicians
Savannah Primary Care Associates LLCGroup PAC ID 4688935760, 36 clinicians

Practice addresses (Care Compare)

1005 Boulder Dr
Gray, GA 31032-6141
Phone (478) 621-2100

1101 Lexington Ave
Savannah, GA 31404-5502
Phone (912) 350-7171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.08 of 100Reported as individual
Quality
74.8
Improvement activities
20

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83263GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Diagnostics LLC Current Accepting new patients
Community Primary Care of Georgia LLC CurrentSince Sep 18, 2023 Accepting new patients
Savannah Primary Care Associates, LLC Internal Medicine CurrentSince Jun 24, 2019 Accepting new patients
Johnson County LTC LLC Past Accepting new patients
Bulloch County LTC LLC Past Accepting new patients
Savannah Health Services, LLC Past Accepting new patients
Candler County LTC LLC Past Accepting new patients
Bibb County Health Care, LLC Past Accepting new patients
Lynn Haven Nursing Home LLC Past Accepting new patients
Glynn County Healthcare, LLC Past Accepting new patients
Toombs Nursing Home LLC Past Accepting new patients
Bulloch County Health Care LLC Past Accepting new patients
Treutlen County Nursing Home LLC Past Accepting new patients
Candler County II LTC LLC PastSince Aug 1, 2023 Accepting new patients
Cherry Blossom Health Care Center LLC Past Accepting new patients
Meadows Park Health & Rehabilitation LLC Past Accepting new patients
Evans County LTC LLC Past Accepting new patients
Riverside Nursing Center of Thomaston LLC Past Accepting new patients
Zebulon Park Health and Rehabilitation LLC Past Accepting new patients
Monroe County Nursing Home LLC Past Accepting new patients

Locations

1005 Boulder Dr
Gray, GA 31032
Phone (478) 621-2072

300 Cedar St
Metter, GA 30439
Phone (912) 685-5703

1101 Lexington Ave
Savannah, GA 31404
Phone (912) 350-7171

1107 E 66th St
Savannah, GA 31404
Phone (912) 350-8404

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/candler-47b034e8

Ownership & related parties

All facility ownership & control disclosures 20

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oxley Park Health and RehabilitationLyons, GA, CCN 115387 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023
Lynn Haven Health and RehabilitationGray, GA, CCN 115474 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025
Autumn Lane Health and RehabilitationGray, GA, CCN 115466 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025
Treutlen County Health and RehabilitationSoperton, GA, CCN 115358 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023
Cherry Blossom Health and RehabilitationMacon, GA, CCN 115652 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025
Bolingreen Health and RehabilitationMacon, GA, CCN 115346 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025
Eagle Health and RehabilitationStatesboro, GA, CCN 115618 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Mar 1, 2025
Azalea Health and RehabilitationMetter, GA, CCN 115642 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023
Orchard Health and RehabilitationPulaski, GA, CCN 115522 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023
Camellia Health and RehabilitationClaxton, GA, CCN 115598 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023
Scott Health and RehabilitationAdrian, GA, CCN 115671 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023
Heritage Inn Health and RehabilitationStatesboro, GA, CCN 115597 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023
Oaks Health Center at the Marshes of Skidaway IslandSavannah, GA, CCN 115715 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2023
Apr 14, 2025
Zebulon Park Health and RehabilitationMacon, GA, CCN 115295 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025
Meadows Park Health & RehabilitationVidalia, GA, CCN 115726 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023
Archway Transitional Care CenterMacon, GA, CCN 115728 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 7, 2025
Mar 7, 2025
Heritage OaksSaint Simons Island, GA, CCN 115582 Skilled nursing facility Adp of the SNF Mar 1, 2025
Affinis HospiceVidalia, GA, CCN 111746 Hospice Operational/Managerial Control (100%) Jul 1, 2025
Affinis HospicePooler, GA, CCN 111771 Hospice Operational/Managerial Control (100%) Jul 1, 2025
Affinis Hospice, LLCGray, GA, CCN 851514 Hospice Operational/Managerial Control (100%) Jul 1, 2025

Owned or controlled facilities with NPI records 20

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 20

Organizations & group practices 20

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 20

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1013304088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BOULDER DR",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310326141",
            "telephone_number": "478-621-2072",
            "fax_number": "678-540-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BOULDER DR",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310326141",
            "telephone_number": "478-874-8368",
            "fax_number": "678-540-8623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_2": "Memorial Health University Medical Center",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314045502",
            "country_code": "US",
            "telephone_number": "912-350-7171",
            "fax_number": "912-350-3454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MAULIKKUMAR",
        "middle_name": "ARVINDBHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "83263",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "83263",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpatel51595@epicsav.hcadirect.net",
            "affiliation": "N",
            "address_1": "1101 Lexington Ave",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314045502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gray, GA

Sources for this page

Verify at the official NPI Registry.