Individual provider Active NPI

Reshma Manhar Patel, M.D.

  • Internal Medicine Physician
  • Lutz, FL
National Provider Identifier
1063649747
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 115056 Issued in FL
Practice address
19105 N US Highway 41
Suite 100
Lutz, FL 33549-4206
Phone
(813) 269-2700
Fax
(813) 269-2701
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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 157040 NC
Internal Medicine Physician 207R00000X ME 115056 FL Primary

Addresses

Primary practice location

19105 N US Highway 41
Suite 100
Lutz, FL 33549-4206

Mailing address

19105 N US Highway 41
Suite 100
Lutz, FL 33549-4206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170130001313 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0244485332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157040NCMDInternal Medicine Physician

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26008/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1063649747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19105 N US HIGHWAY 41",
            "address_2": "SUITE 100",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19105 N US HIGHWAY 41",
            "address_2": "SUITE 100",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494206",
            "telephone_number": "813-269-2700",
            "fax_number": "813-269-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RESHMA",
        "middle_name": "MANHAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "157040",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 115056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.