NPIMap

Individual provider Active NPI

Rutvik S. Patel, M.D.

  • Internal Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1275567166
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01062298A Issued in IN
Practice address
2121 Lake Ave
Fort Wayne, IN 46805-5100
Phone
(217) 714-0220
Fax
(888) 366-1712
NPI assigned
Jul 10, 2006
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01062298A IN Primary
Hospitalist Physician 208M00000X 01062298 IN

Addresses

Primary practice location

2121 Lake Ave
Fort Wayne, IN 46805-5100

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other practice location 1

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Phone (260) 425-6940

Other practice location 2

12515 Golden Harvest Dr
Fort Wayne, IN 46845-9031
Phone (217) 714-0220

Other identifiers 4

IdentifierTypeStateIssuer
000000483128OtherINANTHEM
2679847MedicaidOH
11589279OtherINCAQH
200825660MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061019000520 IN Practitioner - Internal Medicine 7517963242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allen County Internal Medicine PCGroup PAC ID 0143447060, 2 clinicians

Practice addresses (Care Compare)

12515 Golden Harvest Dr
Fort Wayne, IN 46845-9031
Phone (217) 714-0220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01062298INMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen County Internal Medicine PC Internal Medicine CurrentSince Sep 1, 2014 Accepting new patients
Parkview Health System Inc Internal Medicine CurrentSince Apr 10, 2023 Accepting new patients
Medical Group of Fort Wayne, P.C. Internal Medicine Past Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

11104 Parkview Circle Dr
Ste 20
Fort Wayne, IN 46845
Phone (260) 266-2500

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

3534 Brooklyn Ave
Fort Wayne, IN 46809
Phone (219) 478-5180

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

400 W 7th St
North Manchester, IN 46962
Phone (260) 982-8616

Interoperability endpoints

  • Direct secure messaging: rpatel10143@direct.parkviewexchange.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Peabody Retirement CommunityNorth Manchester, IN, CCN 155655 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2014
Jul 1, 2015
Heart to Heart Hospice of Northeast Indiana LLCFort Wayne, IN, CCN 151635 Hospice Contracted Managing Employee Dec 1, 2019

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 12

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1275567166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "217-714-0220",
            "fax_number": "888-366-1712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11109 Parkview Plaza Dr # 117",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451701",
            "country_code": "US",
            "telephone_number": "260-425-6940",
            "fax_number": "260-425-6949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12515 Golden Harvest Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468459031",
            "country_code": "US",
            "telephone_number": "217-714-0220",
            "fax_number": "888-366-1712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RUTVIK",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01062298A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01062298",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000483128",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2679847",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11589279",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200825660",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.