Individual provider Active NPI

Jeetendra B Patel, M.D.

  • Interventional Cardiology Physician
  • Springfield, IL
National Provider Identifier
1255412094
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036173952 Issued in IL
Practice address
619 E Mason St Ste 4P57
Springfield, IL 62701-1034
Phone
(217) 788-0706
Fax
(217) 525-2535
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 036173952 IL Primary
Cardiovascular Disease Physician 207RC0000X 61845 TN
Interventional Cardiology Physician 207RI0011X 61845 TN
Cardiovascular Disease Physician 207RC0000X 0101281934 VA
Interventional Cardiology Physician 207RI0011X 0101281934 VA
Cardiovascular Disease Physician 207RC0000X 036173952 IL

Addresses

Primary practice location

619 E Mason St Ste 4P57
Springfield, IL 62701-1034

Mailing address

619 E Mason St Ste 4P57
Springfield, IL 62701-1034
Phone (217) 788-0706

Other practice location 1

1901 S Shady St
Mountain City, TN 37683-2021
Phone (423) 727-6674

Other practice location 2

1410 Tusculum Blvd Ste 1200
Greeneville, TN 37745-5815
Phone (423) 638-2270

Other practice location 3

115 Judge Gresham Rd Ste A
Gray, TN 37615-6213
Phone (423) 467-3000

Other practice location 4

650 W Taylor St
Vandalia, IL 62471-1227
Phone (618) 283-5463

Other practice location 5

2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396
Phone (423) 262-4400

Other practice location 6

301 Riverview Ave Ste 700
Norfolk, VA 23510-1065
Phone (757) 252-9365

Other practice location 7

329 N State Of Franklin Rd
Johnson City, TN 37604-6062
Phone (423) 979-4100

Other identifiers 4

IdentifierTypeStateIssuer
200951260MedicaidIN
5816058-1205OtherUTUTAH MEDICAL LICENSE NO.
Q060983MedicaidTN
000000662912OtherINANTHEM PROVIDER NUMBER

Other names 1

  • Dr. Jeetendra Bhagubhai Patel Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpatel473190@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN, VA, IL4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20181110000414 GA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 2769534171 Reassigns benefits to 1 organization
I20200825002269 TN Practitioner - Cardiovascular Disease (Cardiology) 2769534171 Reassigns benefits to 1 organization
I20240424000871 VA Practitioner - Interventional CardiologyPractitioner - Internal Medicine 2769534171 Reassigns benefits to 1 organization
I20250311003719 IL Practitioner - Interventional Cardiology 2769534171 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Hillsboro Area Hospital, Inc.Group PAC ID 4486547148, shared by 4 NPIs, 37 clinicians
Prairie Cardiovascular Consultants LTDGroup PAC ID 3173435880, 94 clinicians
Thomas H Boyd Memorial HospitalGroup PAC ID 8123085560, 30 clinicians

Practice addresses (Care Compare)

1200 E Tremont St
Hillsboro, IL 62049-1912
Phone (217) 532-6111

619 E Mason St
4P57
Springfield, IL 62701-1034
Phone (217) 788-0706

800 E Carpenter St
Springfield, IL 62769-0002
Phone 217544646444399

800 School St
Carrollton, IL 62016-1436
Phone (217) 942-6946

Hospital & facility affiliations

  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032
  • St Francis Hospital Hospital, Litchfield, IL, CCN 141350
  • St Marys Hospital Hospital, Decatur, IL, CCN 140166
  • Jacksonville Memorial Hospital Hospital, Jacksonville, IL, CCN 141352

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036173952ILMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Apr 1, 2020 Accepting new patients
Hillsboro Area Hospital, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Hillsboro Area Hospital, Inc. Current Accepting new patients
Pana Community Hospital Association CurrentSince May 10, 2025 Accepting new patients
Thomas H. Boyd Memorial Hospital CurrentSince Feb 7, 2025 Accepting new patients
Hillsboro Area Hospital, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Prairie Cardiovascular Consultants LTD Cardiovascular Disease CurrentSince Mar 31, 2025 Accepting new patients
Phoebe Dorminy Surgical Associates CurrentSince Apr 1, 2020 Accepting new patients
St Johns Hospital of the Hospital Sisters of the Third Order of St F Current Accepting new patients
Thomas H. Boyd Memorial Hospital CurrentSince Feb 7, 2025 Accepting new patients
Pana Community Hospital Association Current Accepting new patients
Medical Education Assistance Corporation Cardiovascular Disease CurrentSince Sep 15, 2020 Accepting new patients
Pana Community Hospital Association CurrentSince May 10, 2025 Accepting new patients
Sentara Medical Group Cardiovascular Disease CurrentSince Apr 1, 2024 Accepting new patients
Wellmont Medical Associates Inc Current Accepting new patients
St Johns Hospital of the Hospital Sisters of the Third Order of St F CurrentSince May 26, 2025 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

800 School St
Carrollton, IL 62016
Phone (217) 942-3600

1200 E Tremont St
Hillsboro, IL 62049
Phone (217) 532-4154

1745 W Walnut St
Jacksonville, IL 62650
Phone (217) 243-6454

101 E 9th St
Ste 105
Pana, IL 62557
Phone (217) 562-2544

101 E 9th St
Pana, IL 62557
Phone (217) 562-2131

619 E Mason St
Ste 4P57
Springfield, IL 62701

800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643

800 E Carpenter St
Springfield, IL 62702
Phone (217) 525-5643

619 E Mason St
#4P57
Springfield, IL 62701

3051 Hollis Dr
Springfield, IL 62704
Phone (217) 523-5406

619 E Mason St
Ste 4
Springfield, IL 62701

650 W Taylor St
Vandalia, IL 62471
Phone (618) 283-1231

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

329 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

1901 S Shady St
Ste 1
Mountain City, TN 37683
Phone (423) 727-1103

1901 S Shady St
Mountain City, TN 37683
Phone (423) 727-1100

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

301 Riverview Ave
Ste 700
Norfolk, VA 23510
Phone (757) 252-9365

Interoperability endpoints

  • Direct secure messaging: jpatel965362@direct.sentara.net
  • Direct secure messaging: jpatel473190@ewd.direct.hshs.org

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 6

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.

{
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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1255412094",
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            "fax_number": "217-525-2535"
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        {
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            "fax_number": "217-525-2535"
        }
    ],
    "practiceLocations": [
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            "address_1": "1901 S Shady St",
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            "state": "TN",
            "postal_code": "376832021",
            "country_code": "US",
            "telephone_number": "423-727-6674",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1410 Tusculum Blvd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377455815",
            "country_code": "US",
            "telephone_number": "423-638-2270",
            "country_name": "United States",
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        },
        {
            "address_1": "115 Judge Gresham Rd Ste A",
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        },
        {
            "address_1": "650 W Taylor St",
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            "postal_code": "624711227",
            "country_code": "US",
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            "country_name": "United States",
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        {
            "address_1": "2428 Knob Creek Rd Ste 201",
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            "country_code": "US",
            "telephone_number": "423-262-4400",
            "fax_number": "423-262-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Riverview Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235101065",
            "country_code": "US",
            "telephone_number": "757-252-9365",
            "fax_number": "757-962-7217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "329 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046062",
            "country_code": "US",
            "telephone_number": "423-979-4100",
            "fax_number": "423-979-4134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JEETENDRA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
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            "license": "036173952",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "61845",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
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            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036173952",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200951260",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH MEDICAL LICENSE NO.",
            "identifier": "5816058-1205",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q060983",
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        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000662912",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpatel473190@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "619 E Mason St Ste 4P57",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627011034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEETENDRA",
            "last_name": "PATEL",
            "middle_name": "BHAGUBHAI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.