Individual provider Active NPI

Shivam Hasmukh Patel, MD

  • Ophthalmology Physician
  • Indianapolis, IN
National Provider Identifier
1679035018
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01090571A Issued in IN
Practice address
1633 N Capitol Ave Ste 640
Indianapolis, IN 46202-1281
Phone
(317) 962-8881
NPI assigned
Apr 4, 2019
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 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 NU
Ophthalmology Physician 207W00000X 01090571A IN Primary

Addresses

Primary practice location

1633 N Capitol Ave Ste 640
Indianapolis, IN 46202-1281

Mailing address

1633 N Capitol Ave Ste 640
Indianapolis, IN 46202-1281
Phone (317) 962-8881

Other practice location 1

720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone (317) 880-8546

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spatel@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230614002674 IN Practitioner - Ophthalmology 6406189356 Reassigns benefits to 1 organization
I20250729000643 OH Practitioner - Ophthalmology 6406189356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Saint Louis University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Retina, IncGroup PAC ID 0244207074, 9 clinicians

Practice addresses (Care Compare)

1600 Gateway Cir
Grove City, OH 43123-8650
Phone (614) 339-8500

2935 Maple Ave
Zanesville, OH 43701-1487
Phone (614) 339-8500

6573 E Broad St
Suite B
Columbus, OH 43213-1509
Phone (614) 339-8500

6655 Post Rd
Dublin, OH 43016-8214
Phone (614) 339-8500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01090571AINMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Jul 5, 2023 Accepting new patients
University Family Physicians, Inc. CurrentSince Jul 5, 2023 Accepting new patients
Midwest Retina, Inc Ophthalmology CurrentSince Sep 1, 2025 Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

262 Neil Ave
Ste 330
Columbus, OH 43215

6573 E Broad St
Ste B
Columbus, OH 43213

6655 Post Rd
Dublin, OH 43016

1600 Gateway Cir
Grove City, OH 43123
Phone (614) 274-2020

466 S Trimble Rd
Mansfield, OH 44906
Phone (419) 756-8000

2935 Maple Ave
Zanesville, OH 43701
Phone (614) 233-9500

Interoperability endpoints

  • Direct secure messaging: shivam.patel.p1@direct.midwestretina.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1679035018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 N CAPITOL AVE STE 640",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021281",
            "telephone_number": "317-962-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 N CAPITOL AVE STE 640",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021281",
            "telephone_number": "317-962-8881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Eskenazi Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025187",
            "country_code": "US",
            "telephone_number": "317-880-8546",
            "fax_number": "317-880-0438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIVAM",
        "middle_name": "HASMUKH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01090571A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spatel@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "720 Eskenazi Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.