Individual provider Active NPI

Mayank S Patel, M.D.

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1699162099
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.145167 Issued in IL
Practice address
2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone
(855) 979-5700
NPI assigned
Apr 23, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036145167 IL
Internal Medicine Physician 207R00000X 036.145167 IL Primary

Addresses

Primary practice location

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (855) 979-5700

Other practice location 1

1500 S. California Ave
F914
Chicago, IL 60608
Phone (773) 257-5914

Other practice location 2

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5714

Other practice location 3

4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 759-4323

Other identifiers 2

IdentifierTypeStateIssuer
036145167OtherILMEDICAL LICENSE
ME159188OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 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
I20181017002308 IL Practitioner - HospitalistPractitioner - Internal Medicine 8325390446 Reassigns benefits to 1 organization
I20230128000493 FL Practitioner - Hospitalist 8325390446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-1000

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

3434 Hancock Bridge Pkwy
Suite 301
North Fort Myers, FL 33903-7099
Phone (877) 856-3774

Hospital & facility affiliations

  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.145167ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RMH Pathologists, LTD Current Accepting new patients
Rockford Health Physicians CurrentSince Aug 25, 2018 Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince Apr 20, 2023 Accepting new patients
Millennium Physician Group LLC CurrentSince Apr 20, 2023 Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mayank.patel.1@4290.direct.athenahealth.com

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": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1699162099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "855-979-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "855-979-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S. California Ave",
            "address_2": "F914",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60608",
            "country_code": "US",
            "telephone_number": "773-257-5914",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 N Rockton Ave",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "61103",
            "country_code": "US",
            "telephone_number": "815-971-5714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 W Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508409",
            "country_code": "US",
            "telephone_number": "815-759-4323",
            "fax_number": "815-759-4948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MAYANK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036145167",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.145167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "036145167",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME159188",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.