Individual provider Active NPI

Gourav V. Patil, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1609339423
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD19379 Issued in RI
Practice address
1 Warren Way
Providence, RI 02905-5000
Phone
(401) 444-0530
Fax
(401) 444-0423
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD19379 RI Primary

Addresses

Primary practice location

1 Warren Way
Providence, RI 02905-5000

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gpatil72473@HCNetwork.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20240305002962 RI Practitioner - Internal Medicine 8325483993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Providence Community Health Centers Inc.Group PAC ID 9335050962, 90 clinicians

Practice addresses (Care Compare)

1 Warren Way
Providence, RI 02905-5000
Phone (401) 444-0530

Hospital & facility affiliations

  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19379RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Community Health Centers, Inc CurrentSince Dec 29, 2023 Accepting new patients
The Providence Community Health Centers Inc. Past Accepting new patients

Locations

1 Warren Way
Providence, RI 02905
Phone (401) 444-0400

375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400

Interoperability endpoints

  • Direct secure messaging: gpatil72473@hcnetwork.direct-ci.com

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.

Hospital & facility affiliations 5

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1609339423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WARREN WAY",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055000",
            "telephone_number": "401-444-0530",
            "fax_number": "401-444-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIL",
        "first_name": "GOURAV",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD19379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gpatil72473@HCNetwork.direct-ci.com",
            "affiliation": "N",
            "address_1": "1 Warren Way",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029055000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.