Individual provider Active NPI

Nishita D Patel, MD

  • Ophthalmology Physician
  • Daytona Beach, FL
National Provider Identifier
1194048488
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME113176 Issued in FL
Practice address
517 N Clyde Morris Blvd
Daytona Beach, FL 32114-2323
Phone
(386) 425-0393
Fax
(386) 253-3484
NPI assigned
Mar 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME113176 FL Primary

Addresses

Primary practice location

517 N Clyde Morris Blvd
Daytona Beach, FL 32114-2323

Mailing address

517 N Clyde Morris Blvd
Daytona Beach, FL 32114-2323
Phone (386) 425-0393

Other practice location 1

1925 Mizell Ave
Ste 302
Winter Park, FL 32792-4106
Phone (407) 629-6646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120713000474 FL Practitioner - Ophthalmology 9436314606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

1041 Dunlawon Ave
Port Orange, FL 32127-7968
Phone (386) 322-4700

303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709

Hospital & facility affiliations

  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME113176FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc CurrentSince May 18, 2015 Accepting new patients
Donald M. Cardone, M.D., P.a. Ophthalmology PastSince Aug 9, 2010 Accepting new patients

Locations

517 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 255-3444

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

Interoperability endpoints

  • Direct secure messaging: nishita.patel.1@16462.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1194048488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142323",
            "telephone_number": "386-425-0393",
            "fax_number": "386-253-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142323",
            "telephone_number": "386-425-0393",
            "fax_number": "386-253-3484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1925 Mizell Ave",
            "address_2": "Ste 302",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327924106",
            "country_code": "US",
            "telephone_number": "407-629-6646",
            "fax_number": "407-740-5089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NISHITA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME113176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.