Individual provider Active NPI

Mangesh B Patel, MD

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1194781443
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0055966 Issued in FL
Practice address
1030 S 78TH St
Tampa, FL 33619-4750
Phone
(813) 740-0646
Fax
(813) 849-0894
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0055966 FL Primary

Addresses

Primary practice location

1030 S 78TH St
Tampa, FL 33619-4750

Mailing address

1030 S 78TH St
Tampa, FL 33619-4750
Phone (813) 740-0646

Other identifiers 1

IdentifierTypeStateIssuer
371106400MedicaidFL

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
I20110224000904 FL Practitioner - Family Practice 0143364240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0055966FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Health Care Physicians LLC Family Medicine CurrentSince May 1, 2024 Accepting new patients
Phoenix American Medical LLC CurrentSince May 1, 2019 Accepting new patients

Locations

1401 S US Highway 1
Ste 1423
Fort Pierce, FL 34950
Phone (772) 788-2120

634 NE Jensen Beach Blvd
Jensen Beach, FL 34957
Phone (772) 334-6201

13220 Belcher Rd S
Unit 11
Largo, FL 33773
Phone (727) 533-2242

5400 Pinehurst Dr
Spring Hill, FL 34606

14690 Spring Hill Dr
Ste 101
Spring Hill, FL 34609

5350 Spring Hill Dr
Spring Hill, FL 34606
Phone (352) 688-8116

1030 S 78th St
Tampa, FL 33619
Phone (813) 740-0635

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCACBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1194781443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S 78TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194750",
            "telephone_number": "813-740-0646",
            "fax_number": "813-849-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S 78TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194750",
            "telephone_number": "813-740-0646",
            "fax_number": "813-849-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANGESH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0055966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371106400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.