Individual provider Active NPI

Mayur Ashok Patel, M.D.

  • Anesthesiology Physician
  • Mishawaka, IN
National Provider Identifier
1194036236
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01073954A Issued in IN
Practice address
5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone
(574) 233-3123
Fax
(574) 233-3125
NPI assigned
Jun 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 125-056166 IL
Anesthesiology Physician 207L00000X 01073954A IN Primary

Addresses

Primary practice location

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469

Mailing address

PO Box 1742
South Bend, IN 46634-1742
Phone (574) 233-3123

Other identifiers 1

IdentifierTypeStateIssuer
201228330MedicaidIN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140616002318 IN Practitioner - Anesthesiology 2769606672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

1915 Lake Ave
Plymouth, IN 46563-9366
Phone (574) 948-4000

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-5000

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-056166ILMDAnesthesiology Physician
01073954AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Oct 31, 2025 Accepting new patients
Cep America - Anesthesia PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Oct 31, 2025 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Surgery Center Anesthsia Anesthesiology Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181

Interoperability endpoints

  • Direct secure messaging: mpatel1154429@direct.trinity-health.org

Organizations & group practices 7

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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1194036236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1742",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466341742",
            "telephone_number": "574-233-3123",
            "fax_number": "574-233-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-233-3123",
            "fax_number": "574-233-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MAYUR",
        "middle_name": "ASHOK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125-056166",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01073954A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201228330",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.