Active NPI
Mayur Ashok Patel, M.D.
- Anesthesiology Physician
- Mishawaka, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01073954A
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201228330 | Medicaid | IN |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125-056166 | IL | MD | Anesthesiology Physician |
| 01073954A | IN | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Joseph Regional Medical Center-South Bend Campus, Inc | Anesthesiology | Current | Accepting new patients |
| Saint Joseph Regional Medical Center-South Bend Campus, Inc. | Current | Accepting new patients | |
| Cep America - Anesthesia PC | Anesthesiology | Current | Accepting new patients |
| Cep America - Anesthesia PC | Anesthesiology | Current | Accepting new patients |
| Cep America - Anesthesia PC | Anesthesiology | Current | 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
- 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.
-
- Anesthesiology Physician
- Mishawaka, IN
- NPI 1306722418
Anesthesiology, IN
-
- Mobile Mammography Clinic/Center
- South Bend, IN
- NPI 1023844693
IN
-
- Critical Care Medicine (Internal Medicine) Physician
- Mishawaka, IN
- NPI 1699132365
Anesthesiology
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1841245594
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1023965795
Hospital
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1841245594
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.