Individual provider Active NPI

Nikhil Kanti Patel, M.D.

  • Neurological Surgery Physician
  • Maywood, IL
National Provider Identifier
1629229950
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
125051467 Issued in IL
Practice address
2160 S 1St Ave
Building 105 Room 1900
Maywood, IL 60153-3328
Phone
(708) 216-5120
Fax
(708) 216-4948
NPI assigned
Oct 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 125051467 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Building 105 Room 1900
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Building 105 Room 1900
Maywood, IL 60153-3328
Phone (708) 216-5120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150120001859 TX Practitioner - Neurosurgery 4587988662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Baylor College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bianco Brain and Spine, LLCGroup PAC ID 8426103243, 5 clinicians
Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

2705 W Arkansas LN
Dalworthington Gardens, TX 76016-5818
Phone (817) 701-4253

350 Mercedes St
Benbrook, TX 76126-2593
Phone (817) 717-5390

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion86
Laminectomy or laminotomy (partial removal of spine bones)25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125051467ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bianco Brain & Spine, LLC Neurological Surgery CurrentSince Jan 1, 2015 Accepting new patients

Locations

1001 N Waldrop Dr
Ste 403
Arlington, TX 76012
Phone (817) 468-4343

2705 W Arkansas Ln
Dwg, TX 76016
Phone (817) 701-4253

Interoperability endpoints

  • Direct secure messaging: nikhil.patel.1@28321.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1629229950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "BUILDING 105 ROOM 1900",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5120",
            "fax_number": "708-216-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "BUILDING 105 ROOM 1900",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5120",
            "fax_number": "708-216-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIKHIL",
        "middle_name": "KANTI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "125051467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.