Individual provider Active NPI

Pratikkumar Patel, D.O.

  • Cardiovascular Disease Physician
  • Conyers, GA
National Provider Identifier
1356789200
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
92581 Issued in GA
Practice address
1412 Milstead Ave NE Ste 100
Conyers, GA 30012-3877
Phone
(770) 483-9330
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PG163291 OR
Cardiovascular Disease Physician 207RC0000X H87177 MD
Cardiovascular Disease Physician 207RC0000X 92581 GA Primary

Addresses

Primary practice location

1412 Milstead Ave NE Ste 100
Conyers, GA 30012-3877

Mailing address

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-4906

Other practice location 1

12502 Willowbrook Rd Ste 420
Cumberland, MD 21502-6567
Phone (240) 964-8740

Other practice location 2

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-4906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, 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
I20190819003373 MD Practitioner - Cardiovascular Disease (Cardiology) 0042506792 Reassigns benefits to 1 organization
I20220913000172 GA Practitioner - Cardiovascular Disease (Cardiology) 0042506792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

Hospital & facility affiliations

  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
  • Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046
  • Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PG163291ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC Cardiovascular Disease CurrentSince Feb 10, 2026 Accepting new patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Aug 22, 2022 Accepting new patients
Upmc Western Maryland Corporation Internal Medicine Current Accepting new patients
Upmc Western Maryland Corporation CurrentSince Aug 5, 2019 Accepting new patients
Upmc Western Maryland Corporation CurrentSince Aug 5, 2019 Accepting new patients
Upmc Western Maryland Corporation Past Accepting new patients
Upmc Western Maryland Health Services, LLC Internal Medicine Past Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1412 Milstead Ave NE
Ste 100
Conyers, GA 30012
Phone (770) 483-9330

2151 W Spring St
Ste B150
Monroe, GA 30655

2151 W Spring St
Ste B220
Monroe, GA 30655
Phone (770) 267-1895

1855 Hudson Bridge Rd
Stockbridge, GA 30281
Phone (678) 565-0648

12502 Willowbrook Rd
Ste 470
Cumberland, MD 21502
Phone (240) 964-8724

12502 Willowbrook Rd
Ste 420
Cumberland, MD 21502
Phone (240) 964-8740

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

1313 National Hwy
Lavale, MD 21502
Phone (240) 362-0288

Organizations & group practices 7

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 5

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1356789200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-768-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE STE 100",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "770-483-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12502 Willowbrook Rd Ste 420",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215026567",
            "country_code": "US",
            "telephone_number": "240-964-8740",
            "fax_number": "240-964-8741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-4906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRATIKKUMAR",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "PG163291",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "H87177",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "92581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.