Individual provider Active NPI

Alpa Mahendra Patel, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Rockford, IL
National Provider Identifier
1356543375
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
97052 Issued in GA
Practice address
5666 E State St
Rockford, IL 61108-2425
Phone
(815) 381-7715
NPI assigned
Jun 1, 2007
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 36116438 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 97052 GA Primary
Hospitalist Physician 208M00000X 036116438 IL

Addresses

Primary practice location

5666 E State St
Rockford, IL 61108-2425

Mailing address

1581 Spruce CT
Lombard, IL 60148-4245
Phone (630) 495-8534

Other practice location 1

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, GA2 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
I20080102000012 IL Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Geriatric Medicine 6901986082 Reassigns benefits to 2 organizations
I20240227001348 GA Practitioner - Internal Medicine 6901986082 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
97052GAMDGeriatric Medicine (Internal Medicine) Physician
36116438ILMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Illinois, LLC Hospitalist CurrentSince Jul 1, 2015 Accepting new patients
North Atlanta Professional Services LLC Hospitalist CurrentSince Apr 1, 2024 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Midwest Dysphagia Consultants, LLC Past Accepting new patients

Locations

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

Interoperability endpoints

  • Direct secure messaging: apatel87465@direct.luhs.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1356543375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1581 SPRUCE CT",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484245",
            "telephone_number": "630-495-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5666 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082425",
            "telephone_number": "815-381-7715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Northside Forsyth Dr",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417659",
            "country_code": "US",
            "telephone_number": "770-844-3200",
            "fax_number": "770-844-3227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ALPA",
        "middle_name": "MAHENDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "36116438",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "97052",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036116438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.