Individual provider Active NPI

Bachu C Patel, MD

  • Family Medicine Physician
  • Melbourne, FL
National Provider Identifier
1386741890
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME44043 Issued in FL
Practice address
469 N Harbor City Blvd
Melbourne, FL 32935-6857
Phone
(321) 254-2321
Fax
(321) 254-2011
NPI assigned
Sep 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME44043 FL Primary

Addresses

Primary practice location

469 N Harbor City Blvd
Melbourne, FL 32935-6857

Mailing address

221 W Hibiscus Blvd # 401
Melbourne, FL 32901-3044
Phone (321) 794-8547

Other identifiers 1

IdentifierTypeStateIssuer
069835100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100830000680 FL Practitioner - Family Practice 1658363742 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME44043FLMDFamily Medicine Physician
4403FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Patel Family Medicine PA Family Medicine CurrentSince Jan 18, 2011 Accepting new patients
Chandra, Gayden, Patel and Associates PastSince Oct 1, 1988 Accepting new patients

Locations

221 W Hibiscus Blvd
Melbourne, FL 32901
Phone (321) 794-8547

469 N Harbor City Blvd
Melbourne, FL 32935
Phone (321) 254-2321

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1386741890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W HIBISCUS BLVD # 401",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013044",
            "telephone_number": "321-794-8547",
            "fax_number": "321-610-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 N HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356857",
            "telephone_number": "321-254-2321",
            "fax_number": "321-254-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BACHU",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-19",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME44043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069835100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.