Individual provider Active NPI

Vatsal Patel, D.O.

  • Internal Medicine Physician
  • Evanston, IL
National Provider Identifier
1639458763
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125060075 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1718
Phone
(847) 570-2000
NPI assigned
Aug 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125060075 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1718

Mailing address

2650 Ridge Avenue
Graduate Medical Education - Internal Medicine Office
Evanston, IL 60201
Phone (847) 570-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150123001910 IN Practitioner - Internal Medicine 7416179981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-7005

9130 Columbia Ave
Munster, IN 46321-2932

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125060075ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Internal Medicine CurrentSince Nov 29, 2014 Accepting new patients

Locations

4321 Fir St
Fl 4
East Chicago, IN 46312
Phone (219) 364-3811

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

3630 Willowcreek Rd
Fl 3
Portage, IN 46368
Phone (219) 364-3800

9660 Wicker Ave
Saint John, IN 46373
Phone (219) 226-2203

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Powers HealthEast Chicago, IN, CCN 150008 Hospital Corporate Director Jul 1, 2021
Hammond-Whiting Care CenterWhiting, IN, CCN 155423 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Aug 1, 2021
Feb 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 2

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": "1312675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1639458763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVENUE",
            "address_2": "GRADUATE MEDICAL EDUCATION - INTERNAL MEDICINE OFFICE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VATSAL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-07",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125060075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.