Nitin C Patel, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

036-135269 Issued in IL

Practice address

1100 Club Village Dr
Ste 102
Columbia, MO 65203-4411

Phone

(573) 447-4400

Fax

(573) 303-0140

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nitinpatel@siusm.allscriptsdirect.net
• Direct secure messaging: npatelmd264467@carlehiedirect.net

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.

• Carle Health Care Incorporated

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment NPD
• Southern Illinois Medical Services, NFP

  dba SIH Medical Group

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment NPD
• Board of Trustees of Southern Illinois University

  dba Carbondale Care A Van

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Neurology

  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1144267865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CLUB VILLAGE DR",
            "address_2": "STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034411",
            "telephone_number": "573-447-4400",
            "fax_number": "573-303-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CLUB VILLAGE DR",
            "address_2": "STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034411",
            "telephone_number": "573-447-4400",
            "fax_number": "573-303-0140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W Jackson St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011474",
            "country_code": "US",
            "telephone_number": "618-351-4972 x65869",
            "fax_number": "618-351-6522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NITIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "MD113716",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IL",
            "license": "036-135269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "370009866",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208870808",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "npatel15920@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 103",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npatel15920@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 103",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hardik Patel, DO
• Harsha N Patel, M.D.
• Janki Patel, DO
• Jay Patel, MD
• Kepal Patel, D.M.D.
• Purav Patel, M.D.
• Purvi G. Patel, M.D.
• Ravi Patel, MD
• Rohan Asit Patel, MD
• Ronak Rajeshkumar Patel, RN

• Neurology with Special Qualifications in Child Neurology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.

Verify at the official NPI Registry.