Active NPI
Ishan Patel, MD
- Orthopaedic Surgery Physician
- Canton, MI
National Provider Identifier
1053931493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 01099195A
- Practice address
- 667 Reef Dr
Canton, MI 48187-0105 - Phone
- (734) 512-7777
- NPI assigned
- Apr 24, 2020
- Last updated
- Oct 1, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthopaedic Surgery Physician | 207X00000X | 01099195A | IN | Primary |
Addresses
Primary practice location
667 Reef Dr
Canton, MI 48187-0105
Mailing address
667 Reef Dr
Canton, MI 48187-0105
Phone (734) 512-7777
Other practice location 1
4201 St. Antoine St
Uhc-9C
Detroit, MI 48201
Phone (313) 745-5416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200519000460 | MI | Order and Referring Only - Orthopedic Surgery | 2769813195 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01099195A | IN | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Physician Network | Past | Accepting new patients |
Interoperability endpoints
- ipatel879293@direct.centracare.com
Organizations & group practices 1
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.
-
- Clinic/Center
- Lafayette, IN
- NPI 1992543250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790812800000",
"number": "1053931493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "667 REEF DR",
"city": "CANTON",
"state": "MI",
"postal_code": "481870105",
"telephone_number": "734-512-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "667 REEF DR",
"city": "CANTON",
"state": "MI",
"postal_code": "481870105",
"telephone_number": "734-512-7777"
}
],
"practiceLocations": [
{
"address_1": "4201 St. Antoine St",
"address_2": "UHC-9C",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "48201",
"country_code": "US",
"telephone_number": "313-745-5416",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "ISHAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-24",
"last_updated": "2026-10-01",
"certification_date": "2026-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IN",
"license": "01099195A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.