Individual provider Active NPI

Pruthvi Patel, M.D.

  • Hepatology Physician
  • Manhasset, NY
National Provider Identifier
1649438441
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hepatology PhysicianTaxonomy code 207RI0008X
License
247052 Issued in NY
Practice address
1155 Northern Blvd
Manhasset, NY 11030-3040
Phone
(516) 407-4000
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hepatology Physician 207RI0008X 247052 NY Primary

Addresses

Primary practice location

1155 Northern Blvd
Manhasset, NY 11030-3040

Mailing address

1 Gustave L Levy PL # 1118
New York, NY 10029-6504

Other practice location 1

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (212) 562-6000

Other practice location 2

1 Healthy Way
Oceanside, NY 11572-1551
Phone (877) 768-8462

Other practice location 3

1 Gustave L Levy Pl
New York, NY 10029-6500
Phone (212) 241-7270

Other practice location 4

1436 Broadway
Hewlett, NY 11557-1405
Phone (516) 563-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20111115000007 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 6901070671 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Icahn School of Medicine at Mount Sinai, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, shared by 32 NPIs, 2,809 clinicians

Practice addresses (Care Compare)

3160 21St St
Long Island City, NY 11106-4520
Phone (718) 808-7325

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247052NYMDHepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Dec 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 7, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Gastroenterology CurrentSince Feb 7, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

2619 Francis Lewis Blvd
Flushing, NY 11358
Phone (718) 224-7186

1436 Broadway
Hewlett, NY 11557
Phone (516) 563-7200

3160 21st St
Long Island City, NY 11106
Phone (718) 808-7300

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

2020 Wantagh Ave
Wantagh, NY 11793
Phone (516) 248-2422

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1649438441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 NORTHERN BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303040",
            "telephone_number": "516-407-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Port Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Roslyn",
            "state": "NY",
            "postal_code": "115761347",
            "country_code": "US",
            "telephone_number": "212-562-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "877-768-8462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296500",
            "country_code": "US",
            "telephone_number": "212-241-7270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1436 Broadway",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571405",
            "country_code": "US",
            "telephone_number": "516-563-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRUTHVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "NY",
            "license": "247052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.