NPIMap

Individual provider Active NPI

Prafullkumar Gordhan Patel, M.D.

  • Internal Medicine Physician
  • Brooklyn Park, MD
National Provider Identifier
1750302154
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D37111 Issued in MD
Practice address
4600 Ritchie Hwy
Brooklyn Park, MD 21225-2753
Phone
(410) 789-1469
Fax
(410) 789-2826
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D37111 MD Primary

Addresses

Primary practice location

4600 Ritchie Hwy
Brooklyn Park, MD 21225-2753

Mailing address

4600 Ritchie Hwy
Brooklyn Park, MD 21225-2753
Phone (410) 789-1469

Other identifiers 1

IdentifierTypeStateIssuer
547481700MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ppatel4600@crisp.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20050826000694 MD Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4981635141 Practice locations: Brooklyn Park, MD

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4600 Ritchie Hwy
Brooklyn Park, MD 21225-2753
Phone (410) 789-1469

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Centerwell Home Health Home health agency, Columbia, MD, CCN 217071
  • Medstar Harbor Hospital Hospital, Baltimore, MD, CCN 210034

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prafullkumar Patel, MD LLC Internal Medicine CurrentSince Jan 1, 1990 Accepting new patients
Physical Rehab Inc PastSince Oct 24, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ppatel23416@direct.umm.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1750302154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 RITCHIE HWY",
            "city": "BROOKLYN PARK",
            "state": "MD",
            "postal_code": "212252753",
            "telephone_number": "410-789-1469",
            "fax_number": "410-789-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 RITCHIE HWY",
            "city": "BROOKLYN PARK",
            "state": "MD",
            "postal_code": "212252753",
            "telephone_number": "410-789-1469",
            "fax_number": "410-789-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRAFULLKUMAR",
        "middle_name": "GORDHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D37111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547481700",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppatel4600@crisp.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4600 Ritchie Hwy",
            "city": "Brooklyn Park",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212252753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn Park, MD

Sources for this page

Verify at the official NPI Registry.