Prabhakar Ashokkumar Patel, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD150069 Issued in OR

Practice address

1900 Woodland Dr
Coos Bay, OR 97420-2045

Phone

(541) 267-5151

Fax

(541) 266-4536

NPI assigned

Sep 1, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Medicare reassignment NPD
• North Bend Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365
  Medicare reassignment NPD
• Bay Area Hospital District

  • Home Health Agency
  • North Bend, OR
  • NPI 1215018197
  NPD
• North Bend Medical Center Inc

  • Clinical Medical Laboratory
  • Coos Bay, OR
  • NPI 1760404396
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1770716144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRABHAKAR",
        "middle_name": "ASHOKKUMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-01",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD150069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NBMC NPI NUMBER",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500612192",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID NUMBER",
            "identifier": "161133",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX ID FOR BILLING",
            "identifier": "930635514",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "R0000WFBTV",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie J Palmer
• Akhila Parepalli
• Macen Donald Parke
• Terry Lee Parthemore II
• Mark Andreas Pasternak, MD
• Ravindra Patel, M.D.
• Jason Allen Paul, PSS, CRM
• Andrea Paullus, RN, RNFA
• Bhavani Peddagovindu, MD
• Ryan D Pederson, D.P.M.

• Internal Medicine Physician in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.