Active NPI
Mita B Patel, M.D.
- Cardiovascular Disease Physician
- Marina del Rey, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- A150310
- Practice address
- 4676 Admiralty Way # 301
Marina del Rey, CA 90292-6601 - Phone
- (310) 673-3945
- Fax
- (310) 673-0273
- NPI assigned
- Aug 6, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 64496 | WI | |
| Internal Medicine Physician | 207R00000X | 125.054484 | IL | |
| Cardiovascular Disease Physician | 207RC0000X | A150310 | CA | Primary |
Addresses
Primary practice location
4676 Admiralty Way # 301
Marina del Rey, CA 90292-6601
Mailing address
9200 W Wisconsin Ave
Division of Cardiology
Milwaukee, WI 53226-3522
Phone (414) 955-6777
Other practice location 1
9200 W Wisconsin Ave
Division of Cardiology
Milwaukee, WI 53226-3522
Phone (414) 955-6777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609032986 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151006003059 | WI | Practitioner - Cardiovascular Disease (Cardiology) | 1557512282 | Reassigns benefits to 2 organizations |
| I20190422001385 | CA | Practitioner - Cardiovascular Disease (Cardiology) | 1557512282 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Rush Medical College of Rush University, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Cedars-Sinai Medical Care Foundation
Practice addresses (Care Compare)
4644 Lincoln Blvd
Suite 113
Marina del Rey, CA 90292-6374
Phone (310) 306-6966
Hospital & facility affiliations
- Cedar-Sinai Marina del Rey Hospital
- Cedars-Sinai Medical Center
- Torrance Memorial Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.054484 | IL | MD | Internal Medicine Physician |
| 64496 | WI | MD | Internal Medicine Physician |
| A150310 | CA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Internal Medicine | Current | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Internal Medicine | Current | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Cedars-Sinai Medical Care Foundation | Current | Accepting new patients | |
| Cedars-Sinai Medical Center | Past | Accepting new patients | |
| Community Memorial Hospital of Menomonee Falls Inc | Past | Accepting new patients | |
| Froedtert Memorial Lutheran Hospital, Inc. | Past | Accepting new patients | |
| Jonathan D. Rand, M.D. Inc | Internal Medicine | Past | Accepting new patients |
| Community Memorial Hospital District | Cardiovascular Disease | Past | Accepting new patients |
| Cedars-Sinai Marina Hospital | Past | Accepting new patients | |
| St. Josephs Community Hospital of West Bend Inc. | Past | Accepting new patients |
Locations
390 N Pacific Coast Hwy
Ste 1055
El Segundo, CA 90245
8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674
4676 Admiralty Way
Ste 301
Marina del Rey, CA 90292
Phone (310) 385-2992
4644 Lincoln Blvd
Ste 113
Marina del Rey, CA 90292
Phone (310) 306-6966
4644 Lincoln Blvd
Ste 102
Marina del Rey, CA 90292
Phone (310) 822-0022
1919 Santa Monica Blvd
Ste 100
Santa Monica, CA 90404
Phone (424) 314-7800
4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540
3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533
Interoperability endpoints
- mpatel221476@direct.cshs.org
Organizations & group practices 12
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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
Internal Medicine, WI
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Internal Medicine, WI
-
- Community/Retail Pharmacy
- Los Angeles, CA
- NPI 1972149292
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
-
- General Acute Care Hospital
- Marina del Rey, CA
- NPI 1942269725
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1639172372
-
- Internal Medicine Physician
- Marina del Rey, CA
- NPI 1033483193
Internal Medicine
-
- Home Health Agency
- Syracuse, NE
- NPI 1578571329
Cardiovascular Disease
-
- General Acute Care Hospital
- Menomonee Falls, WI
- NPI 1609822881
-
- Rehabilitation Hospital Unit
- Wauwatosa, WI
- NPI 1003819475
-
- General Acute Care Hospital
- West Bend, WI
- NPI 1851336044
Hospital & facility affiliations 4
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": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593043200000",
"number": "1609032986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"address_2": "DIVISION OF CARDIOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-955-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4676 ADMIRALTY WAY # 301",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926601",
"telephone_number": "310-673-3945",
"fax_number": "310-673-0273"
}
],
"practiceLocations": [
{
"address_1": "9200 W Wisconsin Ave",
"address_2": "DIVISION OF CARDIOLOGY",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532263522",
"country_code": "US",
"telephone_number": "414-955-6777",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "MITA",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-06",
"last_updated": "2020-06-25",
"certification_date": "2020-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "64496",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125.054484",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "A150310",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1609032986",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marina del Rey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.