NPIMap

Individual provider Active NPI

Amita N Patel, M.D.

  • Nephrology Physician
  • Greenville, MS
National Provider Identifier
1417149253
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
14324 Issued in MS
Practice address
1502 S Colorado St
Greenville, MS 38703-7219
Phone
(662) 334-6448
Fax
(662) 334-6461
NPI assigned
Aug 15, 2007
Last updated
Feb 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 14324 MS Primary

Addresses

Primary practice location

1502 S Colorado St
Greenville, MS 38703-7219

Mailing address

1502 S Colorado St
Greenville, MS 38703-7219
Phone (662) 334-6448

Other identifiers 3

IdentifierTypeStateIssuer
00121838MedicaidMS
133861001MedicaidAR
53529OtherARBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040927000429 AR Practitioner - NephrologyPractitioner - Internal Medicine 6002720281 Reassigns benefits to 1 organization
Practice locations: Lake Village, AR
I20080118000292 MS Practitioner - NephrologyPractitioner - Internal Medicine 6002720281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Kidney Alliance LLCGroup PAC ID 3870834856, 4 clinicians

Practice addresses (Care Compare)

1502 S Colorado St
Greenville, MS 38703-7219
Phone (662) 335-4105

505 Saint Mary St
Lake Village, AR 71653-1722
Phone (870) 265-3837

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Kidney Alliance LLC Nephrology CurrentSince Oct 1, 2021 Accepting new patients
Batesville Emergency Physicians Past Accepting new patients
Northern Mississippi Vascular Access Center Past Accepting new patients
Chicot Memorial Hospital Past Accepting new patients

Locations

505 Saint Mary St
Lake Village, AR
Phone (870) 265-3837

2729 S Highway 65 82
Lake Village, AR 71653
Phone (870) 265-5351

1997 Medical Park Dr
Greenville, MS 38703
Phone (662) 344-7268

1502 S Colorado St
Greenville, MS 38703
Phone (601) 332-9872

Organizations & group practices 5

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 9

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1417149253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S COLORADO ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037219",
            "telephone_number": "662-334-6448",
            "fax_number": "662-334-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S COLORADO ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037219",
            "telephone_number": "662-334-6448",
            "fax_number": "662-334-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMITA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "14324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121838",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133861001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "53529",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.