Individual provider Active NPI

Mahendra M Patel, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1245215599
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
137727 Issued in NY
Practice address
3455 Boston Rd
Bronx, NY 10469-2508
Phone
(718) 798-2236
Fax
(718) 798-0561
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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 137727 NY Primary

Addresses

Primary practice location

3455 Boston Rd
Bronx, NY 10469-2508

Mailing address

4320 Ammendale Rd
Beltsville, MD 20705-1105
Phone (240) 542-4084

Other identifiers 1

IdentifierTypeStateIssuer
00374007MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150928000306 DC Practitioner - Internal Medicine 5890975312 Reassigns benefits to 1 organization
I20161005001017 VA Practitioner - Internal Medicine 5890975312 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Oct 10, 2016 Accepting new patients
Inova Health Care Services CurrentSince Oct 10, 2016 Accepting new patients
Inova Health Care Services Internal Medicine CurrentSince Oct 10, 2016 Accepting new patients
Premier Medical Associate PC Internal Medicine Past Accepting new patients

Locations

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 4

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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1245215599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 AMMENDALE RD",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051105",
            "telephone_number": "240-542-4084",
            "fax_number": "240-542-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692508",
            "telephone_number": "718-798-2236",
            "fax_number": "718-798-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MAHENDRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "137727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00374007",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.