Individual provider Active NPI

Prabhav Patil, M.D.

  • Anesthesiology Physician
  • Youngstown, OH
National Provider Identifier
1356578033
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35.122098 Issued in OH
Practice address
3622 Belmont Ave
Youngstown, OH 44505-1450
Phone
(631) 796-1417
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X MD456783 PA
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 35.122098 OH
Anesthesiology Physician 207L00000X 35.122098 OH Primary

Addresses

Primary practice location

3622 Belmont Ave
Youngstown, OH 44505-1450

Mailing address

3622 Belmont Ave
Youngstown, OH 44505-1450
Phone (631) 796-1417

Other practice location 1

204 W 26th St
Erie, PA 16508-1806
Phone (814) 864-4755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160208002077 PA Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 4880823988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Critical Care (Intensivists)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

204 W 26TH St
Chest Diseases
Erie, PA 16508-1806
Phone (814) 864-4755

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Education and Research Institute Inc CurrentSince Apr 8, 2020 Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

153 E 13th St
Ste 1300
Erie, PA 16503
Phone (814) 452-5081

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

204 W 26th St
Erie, PA 16508
Phone (814) 454-2401

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1356578033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051450",
            "telephone_number": "631-796-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051450",
            "telephone_number": "631-796-1417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 W 26th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165081806",
            "country_code": "US",
            "telephone_number": "814-864-4755",
            "fax_number": "814-864-5430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATIL",
        "first_name": "PRABHAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "PA",
            "license": "MD456783",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "OH",
            "license": "35.122098",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.122098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.