Individual provider Active NPI

Misal Minesh Patel, MD

  • Internal Medicine Physician
  • Pooler, GA
National Provider Identifier
1164855714
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
83110 Issued in GA
Practice address
1000 Towne Center Blvd BLDG 1200
Pooler, GA 31322-4129
Phone
(912) 748-2280
Fax
(912) 748-4988
NPI assigned
Aug 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 83110 GA Primary

Addresses

Primary practice location

1000 Towne Center Blvd BLDG 1200
Pooler, GA 31322-4129

Mailing address

1000 Towne Center Blvd BLDG 1200
Pooler, GA 31322-4129
Phone (912) 748-2280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191001001898 GA Practitioner - Internal Medicine 6608146881 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

1326 Eisenhower Dr
Savannah, GA 31406-3928

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Jul 21, 2020 Accepting new patients
Department of Behavioral Health & Developmental Disabilities CurrentSince Jul 1, 2019 Accepting new patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Jul 21, 2020 Accepting new patients
Department of Behavioral Health & Developmental Disabilities, Ga CurrentSince Jul 1, 2019 Accepting new patients
Saint Joseph'S Hospital, Inc. Past Accepting new patients

Locations

3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

1000 Towne Center Blvd
Ste 701
Pooler, GA 31322
Phone (912) 303-4200

1000 Towne Center Blvd
Bldg 1200
Pooler, GA 31322
Phone (912) 748-2280

1915 Eisenhower Dr
Savannah, GA 31406
Phone (912) 356-2011

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: misal.patel.1@8042.direct.athenahealth.com

Organizations & group practices 6

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 3

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": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1164855714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD BLDG 1200",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224129",
            "telephone_number": "912-748-2280",
            "fax_number": "912-748-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD BLDG 1200",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224129",
            "telephone_number": "912-748-2280",
            "fax_number": "912-748-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MISAL",
        "middle_name": "MINESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "83110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.