Individual provider Active NPI

Mamta Patel, MD

  • Retina Specialist (Ophthalmology) Physician
  • Tampa, FL
National Provider Identifier
1710923768
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
ME148226 Issued in FL
Practice address
13330 Usf Laurel Dr
Tampa, FL 33612-6601
Phone
(813) 821-8038
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME148226 FL
Retina Specialist (Ophthalmology) Physician 207WX0107X ME148226 FL Primary

Addresses

Primary practice location

13330 Usf Laurel Dr
Tampa, FL 33612-6601

Mailing address

13330 Usf Laurel Dr
Tampa, FL 33612-6601
Phone (205) 516-3545

Other identifiers 2

IdentifierTypeStateIssuer
BXA43OtherFLBCBS
286341701MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpatel198916@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, 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
I20111018000619 TX Practitioner - Ophthalmology 9335154863 Reassigns benefits to 1 organization
I20211005001782 FL Practitioner - Ophthalmology 9335154863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Phone (813) 821-8038

13330 Usf Laurel Dr
Tampa, FL 33612-6601

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME148226FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Sep 28, 2021 Accepting new patients
University Medical Service Association Inc CurrentSince Sep 28, 2021 Accepting new patients
Ecscii, PA CurrentSince Oct 25, 2017 Accepting new patients
Ecsc II PA Ophthalmology Current Accepting new patients
University Medical Service Association Inc Current Accepting new patients
Tampa General Hospital Current Accepting new patients
Mamta D Somaiya MD PC Ophthalmology PastSince Jan 16, 2006 Accepting new patients
Bert M. Glaser National Retina Institute, LLC Ophthalmology Past Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

13330 Usf Laurel Dr
Fl 4
Tampa, FL 33612
Phone (813) 821-8022

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

5421 La Sierra Dr
Dallas, TX 75231
Phone (214) 696-0526

4501 Joe Ramsey Blvd E
Ste 220
Greenville, TX 75401
Phone (214) 972-2020

Interoperability endpoints

  • Direct secure messaging: mpatel198916@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 9

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 1

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1710923768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13330 USF LAUREL DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126601",
            "telephone_number": "205-516-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13330 USF LAUREL DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126601",
            "telephone_number": "813-821-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MAMTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME148226",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME148226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "BXA43",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286341701",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpatel198916@direct.tgh.org",
            "affiliation": "N",
            "address_1": "13330 Usf Laurel Dr",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336126601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.