Active NPI
Pankaj A Patel, M.D.
- Gastroenterology Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 01049700A
- Practice address
- 17501 Generations Dr
South Bend, IN 46635-1589 - Phone
- (574) 234-0049
- Fax
- (574) 251-2861
- NPI assigned
- Jun 9, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 01049700A | IN | Primary |
Addresses
Primary practice location
17501 Generations Dr
South Bend, IN 46635-1589
Mailing address
17501 Generations Dr
South Bend, IN 46635-1589
Phone (574) 234-0049
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7580376 | Other | IN | AETNA |
| 000000225361 | Other | IN | BCBS |
| 0649925002 | Other | IN | CIGNA |
| 200377140A | Medicaid | IN | |
| 100016227 | Other | IN | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- 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
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
17501 Generations Dr
South Bend, IN 46635-1589
Phone (574) 234-0049
Hospital & facility affiliations
- Saint Joseph Regional Medical Center
- Memorial Hospital of South Bend
Merit-based Incentive Payment System (MIPS)
- Final score
- 54.01 of 100
- Quality
- 0
- Improvement activities
- 40
- Cost
- 80.03
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 156 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 249 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01049700A | IN | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michiana Gastroenterology, Inc | Gastroenterology | Current | Accepting new patients |
| MG Anesthesia, LLC | Past | Accepting new patients |
Locations
900 I St
Laporte, IN 46350
Phone (219) 324-1670
1919 Lake Ave
Plymouth, IN 46563
Phone (219) 236-1888
17501 Generations Dr
South Bend, IN 46635
Phone (574) 234-0049
53830 Generations Dr
South Bend, IN 46635
Phone (574) 217-0174
211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331
Interoperability endpoints
- ppatel1158731@direct.trinity-health.org
Organizations & group practices 2
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.
-
- Gastroenterology Physician
- South Bend, IN
- NPI 1821094525
-
- Anesthesiology Physician
- South Bend, IN
- NPI 1942647219
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1023965795
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1841245594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295568000000",
"number": "1124022082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17501 GENERATIONS DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351589",
"telephone_number": "574-234-0049",
"fax_number": "574-251-2861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17501 GENERATIONS DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351589",
"telephone_number": "574-234-0049",
"fax_number": "574-251-2861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "PANKAJ",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-09",
"last_updated": "2011-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IN",
"license": "01049700A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7580376",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000225361",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0649925002",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200377140A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "100016227",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.