Active NPI
Mitulkumar P Patel, M.D.
- Internal Medicine Physician
- Las Vegas, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 10855
- Practice address
- 4880 Wynn Rd
Las Vegas, NV 89103-5406 - Phone
- (702) 871-5005
- Fax
- (702) 671-6883
- NPI assigned
- Sep 20, 2005
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 10855 | NV | Primary |
| Internal Medicine Physician | 207R00000X | G74858 | CA |
Addresses
Primary practice location
4880 Wynn Rd
Las Vegas, NV 89103-5406
Mailing address
PO Box 1737
Las Vegas, NV 89125-1737
Phone (702) 671-6809
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100507193 | Medicaid | NV | |
| CS12512 | Other | NV | PHARMACY/CONTROLLED SUBSTANCE CERTIFICATE |
| 10855 | Other | NV | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- R Franklin University of Med & Sci/Chicago Medical School, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5850 S Polaris Rd
Suite 100
Las Vegas, NV 89118-3185
Phone (702) 739-9957
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 20 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G74858 | CA | MD | Internal Medicine Physician |
| 10855 | NV | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Current Care PA | Current | Accepting new patients | |
| Innovative Wound Management, LLC | Current | Accepting new patients | |
| Intermountain Medical Holdings Nevada Inc | Internal Medicine | Past | Accepting new patients |
Locations
149 N Gibson Rd
Ste H
Henderson, NV 89014
Phone (702) 558-6275
5850 Polaris Ave
Ste 100
Las Vegas, NV 89118
Phone (702) 739-9957
8551 W Lake Mead Blvd
Ste 200
Las Vegas, NV 89128
Phone (702) 869-8720
255 Glendale Ave
Ste 12
Sparks, NV 89431
Phone (775) 356-8181
Organizations & group practices 3
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.
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Addison, TX
- NPI 1275714677
NV
-
- Specialist
- Las Vegas, NV
- NPI 1851110837
-
dba Intermountain Health
- Internal Medicine Physician
- Henderson, NV
- NPI 1245997279
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Las Vegas, NV
- NPI 1750854451
-
- Home Health Agency
- Las Vegas, NV
- NPI 1710691449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1093701674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1737",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891251737",
"telephone_number": "702-671-6809",
"fax_number": "702-671-6883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4880 WYNN RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891035406",
"telephone_number": "702-871-5005",
"fax_number": "702-671-6883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "MITULKUMAR",
"middle_name": "P",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NV",
"license": "10855",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G74858",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100507193",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY/CONTROLLED SUBSTANCE CERTIFICATE",
"identifier": "CS12512",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "10855",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.