Individual provider Active NPI

Bhavesh Madhusudan Patel, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1063948040
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT212960 Issued in PA
Practice address
3400 Spruce St 100 Centrex
Philadelphia, PA 19104
Phone
(215) 662-2532
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT213803 PA
Internal Medicine Physician 207R00000X MT212960 PA Primary

Addresses

Primary practice location

3400 Spruce St 100 Centrex
Philadelphia, PA 19104

Mailing address

3400 Spruce St 100 Centrex
Philadelphia, PA 19104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210614003498 PA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 6406256361 Reassigns benefits to 2 organizations
I20251003001500 GA Practitioner - Critical Care (Intensivists) 6406256361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choa Hospital Based, LLCGroup PAC ID 4688812498, 97 clinicians

Practice addresses (Care Compare)

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117
Phone (404) 785-5437

Hospital & facility affiliations

  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT212960PAMDInternal Medicine Physician
MT213803PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Jul 1, 2021 Accepting new patients
University of Penn - Medical Group Internal Medicine CurrentSince Jun 21, 2021 Accepting new patients
Choa Hospital Based, LLC Pediatrics CurrentSince Aug 5, 2025 Accepting new patients
Choa Multispecialty, LLC Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Jul 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 21, 2021 Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients

Locations

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

2220 N Druid Hills Rd NE
Brookhaven, GA 30329
Phone (404) 778-1440

3400 Spruce St
Rm 100
Philadelphia, PA 19104
Phone (215) 662-2200

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

Organizations & group practices 9

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1063948040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST 100 CENTREX",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST 100 CENTREX",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BHAVESH",
        "middle_name": "MADHUSUDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT213803",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT212960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.