Individual provider Active NPI

Ravi J Patel, M.D.

  • Gastroenterology Physician
  • South Bend, IN
National Provider Identifier
1750607354
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
60680-20 Issued in WI
Practice address
17501 Generations Dr
South Bend, IN 46635
Phone
(574) 234-0049
Fax
(574) 234-0053
NPI assigned
Apr 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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 60680-20 WI
Gastroenterology Physician 207RG0100X 60680-20 WI Primary

Addresses

Primary practice location

17501 Generations Dr
South Bend, IN 46635

Mailing address

17501 Generations Dr
South Bend, IN 46635-1589
Phone (574) 234-0049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180730001281 IN Practitioner - Internal Medicine 9133425622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michiana Gastroenterology, IncGroup PAC ID 2163529892, 12 clinicians

Practice addresses (Care Compare)

17501 Generations Dr
South Bend, IN 46635-1589
Phone (574) 234-0049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
43.26 of 100Reported as individual
Quality
0
Improvement activities
40
Cost
44.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy122
Upper gastrointestinal (GI) endoscopy for acid reflux220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60680-20WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michiana Gastroenterology, Inc Gastroenterology CurrentSince Jul 1, 2018 Accepting new patients
MG Anesthesia, LLC PastSince Jul 1, 2018 Accepting new patients
The South Bend Clinic LLC Past Accepting new patients

Locations

17501 Generations Dr
South Bend, IN 46635
Phone (574) 234-0049

53830 Generations Dr
South Bend, IN 46635
Phone (574) 217-0174

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

Interoperability endpoints

  • Direct secure messaging: rpatel1154397@direct.trinity-health.org

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 5

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": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1750607354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17501 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351589",
            "telephone_number": "574-234-0049",
            "fax_number": "574-234-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17501 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46635",
            "telephone_number": "574-234-0049",
            "fax_number": "574-234-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RAVI",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "60680-20",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "60680-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.