Individual provider Active NPI

Manishkumar Patel, MD

  • Internal Medicine Physician
  • Adrian, MI
National Provider Identifier
1245717339
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4351036568 Issued in MI
Practice address
781 Lakeshire TRL
Adrian, MI 49221-1561
Phone
(517) 265-0600
NPI assigned
Jul 23, 2018
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 4351036568 MI
Internal Medicine Physician 207R00000X 4351036568 MI Primary

Addresses

Primary practice location

781 Lakeshire TRL
Adrian, MI 49221-1561

Mailing address

333 N Summit St FL 7
Toledo, OH 43604-1531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpatel249933@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220919000581 MI Practitioner - Internal Medicine 4981953585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

781 Lakeshire TRL
Adrian, MI 49221-1561
Phone (517) 265-0600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351036568MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Corporation of Michigan Family Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

781 Lakeshire Trl
Adrian, MI 49221
Phone (517) 263-2187

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

Interoperability endpoints

  • Direct secure messaging: mpatel249933@direct.promedica.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1245717339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 LAKESHIRE TRL",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211561",
            "telephone_number": "517-265-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANISHKUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-23",
        "last_updated": "2023-11-03",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351036568",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351036568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpatel249933@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.