NPIMap

Individual provider Active NPI

Kanu Patel, M.D.

  • Internal Medicine Physician
  • Stoneham, MA
National Provider Identifier
1700827938
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
55972 Issued in MA
Practice address
92 Montvale Ave
Suite 2200
Stoneham, MA 02180-3647
Phone
(781) 279-2030
Fax
(781) 279-2078
NPI assigned
Jun 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 55972 MA Primary
Internal Medicine Physician 207R00000X 7381 NH

Addresses

Primary practice location

92 Montvale Ave
Suite 2200
Stoneham, MA 02180-3647

Mailing address

92 Montvale Ave
Suite 2200
Stoneham, MA 02180-3647
Phone (781) 279-2030

Other identifiers 6

IdentifierTypeStateIssuer
3017575MedicaidMA
04-04199OtherMAUNITED
64613OtherMAHARVARD PILGRIM
J05889OtherMABLUE CROSS BLUE SHIELD
055972OtherMATUFTS
110092930OtherMARAILROAD MEDICARE/UNITED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027001389 MA Practitioner - Internal Medicine 9032136163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

92 Montvale Ave
Suite 2200
Stoneham, MA 02180-3657
Phone (781) 279-2030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.31 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
81.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55972MAMDInternal Medicine Physician
7381NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Melrose Wakefield Emergency Physicians, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kanu.patel@elincdirect.org
  • Direct secure messaging: kpatel53547@tuftsmedicine.direct-ci.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 8

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700827938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE",
            "address_2": "SUITE 2200",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803647",
            "telephone_number": "781-279-2030",
            "fax_number": "781-279-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE",
            "address_2": "SUITE 2200",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803647",
            "telephone_number": "781-279-2030",
            "fax_number": "781-279-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KANU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "55972",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "7381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3017575",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "04-04199",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "64613",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J05889",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "055972",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE/UNITED",
            "identifier": "110092930",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.