Individual provider Active NPI

Mukund B. Patel, M.D.

  • Anesthesiology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1447297122
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME130631 Issued in FL
Practice address
4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone
(954) 493-5005
Fax
(954) 938-0957
NPI assigned
Jun 1, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME130631 FL Primary

Addresses

Primary practice location

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Other identifiers 1

IdentifierTypeStateIssuer
200142520MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME130631FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Porter County Anesthesia Associates PC Anesthesiology CurrentSince Oct 1, 2003 Accepting new patients
Sda Consultants PLLC Anesthesiology CurrentSince Aug 11, 2019 Accepting new patients

Locations

9075 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 393-9898

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

1900 Roosevelt Rd
Valparaiso, IN 46383
Phone (219) 263-4900

2206 Roosevelt Rd
Ste B
Valparaiso, IN 46383
Phone (219) 464-9507

814 Laporte Ave
Valparaiso, IN 46383
Phone (219) 263-4600

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

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, 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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447297122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "855-851-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 N FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084603",
            "telephone_number": "954-493-5005",
            "fax_number": "954-938-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MUKUND",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME130631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200142520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.