Individual provider Active NPI

Ghanshyam N Patel, MD

  • Gastroenterology Physician
  • Clinton Township, MI
National Provider Identifier
1558360669
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
GP040631 Issued in MI
Practice address
18645 Canal Rd
Suite 3
Clinton Township, MI 48038-5822
Phone
(586) 228-7568
Fax
(586) 228-7644
NPI assigned
Jul 20, 2005
Last updated
Nov 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X GP040631 MI Primary

Addresses

Primary practice location

18645 Canal Rd
Suite 3
Clinton Township, MI 48038-5822

Mailing address

PO Box 380476
Clinton Township, MI 48038-0066
Phone (586) 228-7568

Other identifiers 1

IdentifierTypeStateIssuer
3279758MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GP040631MIMDGastroenterology Physician

Interoperability endpoints

  • Direct secure messaging: gpatel63391@direct.hfhs.org

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, 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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1558360669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 380476",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480380066",
            "telephone_number": "586-228-7568",
            "fax_number": "586-228-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18645 CANAL RD",
            "address_2": "SUITE 3",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385822",
            "telephone_number": "586-228-7568",
            "fax_number": "586-228-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "GHANSHYAM",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "GP040631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3279758",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.